SHEPHERD'S HILL ACADEMY, INC (NPI# 1902163520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902163520 |
| Entity Type | Organization |
| Organization Name | SHEPHERD'S HILL ACADEMY, INC |
| Practice Address |
2200 Price Rd Martin GA 30557-3457 |
| Practice Telephone | 7067795736 |
| Practice Fax Number | 7067795052 |
| Mailing Telephone | 7067795736 |
| Mailing Fax Number | 7067795052 |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |
| Authorized Official Name | MRS. BETH EMBRY (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 7067795736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | OCCP001025 | GA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437519451 | Shepherd's Hill Academy, Inc | Substance Abuse Rehabilitation Facility | 2200 Price Rd, Martin, GA 30557-3457 | 2016-03-03 |
| Street Address |
2200 PRICE RD |
| City | MARTIN |
| State | GA |
| Zip Code | 30557-3457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144885450 | Elise Embrick Thrift | Counselor | 2200 Price Rd, Martin, GA 30557-3457 | 2019-05-02 |
| 1982116992 | Victoria Nolen | Counselor | 2200 Price Rd, Martin, GA 30557-3457 | 2017-10-31 |
| 1558809822 | Ernest Prow IIi | Counselor | 2200 Price Rd, Martin, GA 30557-3457 | 2017-02-07 |
| 1629439716 | Vikki Paese | Counselor | 2200 Price Rd, Martin, GA 30557-3457 | 2016-03-16 |
| 1437519451 | Shepherd's Hill Academy, Inc | Substance Abuse Rehabilitation Facility | 2200 Price Rd, Martin, GA 30557-3457 | 2016-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629609334 | Kimberly Petenbrink | Technician | 117 Landrum Dr, Martin, GA 30557-2546 | 2020-01-31 |
| 1952378408 | Karen S.p. Eschedor | Family Medicine | 4948 Gumlog Rd, Martin, GA 30557-2921 | 2006-03-03 |
| 1962053173 | Jaime Neill | Technician | 17139 Highway 17, Martin, GA 30557-3324 | 2019-09-28 |
| 1528113370 | Jennifer Larue Davitt | Registered Nurse | 709 Wilson Rd, Martin, GA 30557-3573 | 2007-01-24 |
| 1619011129 | Whitley, LLC | Registered Nurse | 709 Wilson Rd, Martin, GA 30557-3573 | 2007-02-16 |
| 1538595483 | Estatohe Counseling | Community/Behavioral Health | 1085 Bruce Rd, Martin, GA 30557-4639 | 2013-09-24 |
| 1477975514 | Terry Morris | Counselor | 1085 Bruce Rd, Martin, GA 30557-4639 | 2014-01-08 |
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023543766 | One Heart and One Mind Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5737 Old National Hwy, Suite 300, Atlanta, GA 30349-7410 | 2017-05-01 |
| 1396131249 | There's No Place Like A Loving Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Jardin Ct, Alpharetta, GA 30022-4600 | 2015-04-07 |
| 1912343302 | Our Spot | Residential Treatment Facility, Emotionally Disturbed Children | 1015 E Inman St, Statesboro, GA 30458-2049 | 2013-05-13 |
| 1871879312 | Vision Youth Services Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4228 Redan Rd, Stone Mountain, GA 30083-5040 | 2011-10-28 |
| 1356634034 | Soaring Eagle Children's Group | Residential Treatment Facility, Emotionally Disturbed Children | 3183 Northbrook Dr, Atlanta, GA 30341-4629 | 2011-05-27 |
| 1124330386 | Favorable Network Solutions | Residential Treatment Facility, Emotionally Disturbed Children | 881 Memorial Dr Se, Suite 213, Atlanta, GA 30316-1270 | 2010-07-04 |
| 1467687665 | Positive Impact Hhs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 934 Garden Walk Blvd. # 903, College Park, GA 30349-8508 | 2009-05-18 |
| 1932342235 | The Sanctuary House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 500 John Deere Rd Nw, Monroe, GA 30656-4769 | 2009-04-16 |
| 1417198458 | Naciema Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Stone Rd Sw Apt W8, Atlanta, GA 30331-2920 | 2009-03-22 |
| 1255594974 | Button Up America LLC | Residential Treatment Facility, Emotionally Disturbed Children | 450 Old Peachtree Road, Suite 101, Suwanee, GA 30042 | 2008-07-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.