Organization Active NPI

Professional Youth Services

  • Mental Illness Community Based Residential Treatment Facility
  • Richmond, VA
National Provider Identifier
1023187200
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
PROFESSIONAL YOUTH SERVICES
Practice address
4136 Woodfield Rd
Richmond, VA 23234-3450
Phone
(804) 674-4456
Fax
(804) 674-4458
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jemarn Bernard Thorpe
Title
Cheif Executive Officer
Phone
(804) 674-4460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X VA Primary

Addresses

Primary practice location

4136 Woodfield Rd
Richmond, VA 23234-3450

Mailing address

7206 Hull Street Rd
Suite 102a
Richmond, VA 23235-5827
Phone (804) 674-4460

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023187200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7206 HULL STREET RD",
            "address_2": "SUITE 102A",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232355827",
            "telephone_number": "804-674-4460",
            "fax_number": "804-674-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 WOODFIELD RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232343450",
            "telephone_number": "804-674-4456",
            "fax_number": "804-674-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THORPE",
        "authorized_official_first_name": "JEMARN",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "804-674-4460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.