NPIMap

Organization Active NPI

Youth Villages, Inc

  • Psychiatric Residential Treatment Facility
  • Douglasville, GA
National Provider Identifier
1174694913
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
YOUTH VILLAGES, INC
Practice address
4685 Dorsett Shoals Rd
Douglasville, GA 30135-4921
Phone
(770) 942-2391
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Authorized official

Name
Deneen M Alexander
Title
Director of Finance
Phone
(901) 251-4840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X Primary

Addresses

Primary practice location

4685 Dorsett Shoals Rd
Douglasville, GA 30135-4921

Mailing address

3320 Brother Blvd
Bartlett, TN 38133-8950
Phone (901) 251-4840

Other identifiers 2

IdentifierTypeStateIssuer
330507828BMedicaidGA
330507828AMedicaidGA

Other names 1

  • Inner Harbour Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Youth Villages19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251763200000",
    "number": "1174694913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 BROTHER BLVD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381338950",
            "telephone_number": "901-251-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 DORSETT SHOALS RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301354921",
            "telephone_number": "770-942-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH VILLAGES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-09-01",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "DENEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "901-251-4840"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330507828B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330507828A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Inner Harbour",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; 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.