Active NPI
Mount Rogers Mental Health & Mental Retardation Services Board
- Assisted Living Facility
- Wytheville, VA
National Provider Identifier
1174741268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- ALF115839
- Legal business name
- MOUNT ROGERS MENTAL HEALTH & MENTAL RETARDATION SERVICES BOARD
- Practice address
- 770 W Ridge Rd
Wytheville, VA 24382-1046 - Phone
- (276) 223-3200
- Fax
- (276) 223-0617
- NPI assigned
- Apr 23, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donna M Untiedt
- Title
- Reimbursement Specialist
- Phone
- (276) 223-3206
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | ALF115839 | VA | Primary |
Addresses
Primary practice location
770 W Ridge Rd
Wytheville, VA 24382-1046
Mailing address
770 W Ridge Rd
Wytheville, VA 24382-1046
Phone (276) 223-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ALF115839 | Other | VA | LICENSED ASSISTED LIVING |
National Provider Directory
National Provider Directory- Tax ID family
- Mount Rogers Community
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Wytheville, VA
- NPI 1255365599
-
- Non-emergency Medical Transport (VAN)
- Wytheville, VA
- NPI 1407991284
-
- Intellectual Disabilities Intermediate Care Facility
- Hillsville, VA
- NPI 1598381758
-
- Intellectual Disabilities Intermediate Care Facility
- Wytheville, VA
- NPI 1871123729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1174741268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 W RIDGE RD",
"city": "WYTHEVILLE",
"state": "VA",
"postal_code": "243821046",
"telephone_number": "276-223-3200",
"fax_number": "276-223-0617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 W RIDGE RD",
"city": "WYTHEVILLE",
"state": "VA",
"postal_code": "243821046",
"telephone_number": "276-223-3200",
"fax_number": "276-223-0617"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNT ROGERS MENTAL HEALTH & MENTAL RETARDATION SERVICES BOARD",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "UNTIEDT",
"authorized_official_first_name": "DONNA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "REIMBURSEMENT SPECIALIST",
"authorized_official_telephone_number": "276-223-3206"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "VA",
"license": "ALF115839",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED ASSISTED LIVING",
"identifier": "ALF115839",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wytheville, 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.