NPIMap

Organization Active NPI

Summer House

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Timberville, VA
National Provider Identifier
1245698935
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
SUMMER HOUSE
Practice address
16056 Elderly LN
Timberville, VA 22853-2922
Phone
(804) 612-3312
Fax
(804) 276-5739
NPI assigned
Feb 9, 2016
Last updated
Sep 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Don Kamencik
Title
Cfo
Phone
(804) 864-1320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

16056 Elderly LN
Timberville, VA 22853-2922

Mailing address

5511 Staples Mill Rd
Ste 102
Richmond, VA 23228-5445
Phone (804) 612-3312

National Provider Directory

National Provider Directory
Tax ID family
Intercept Youth Services Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

16056 Elderly Ln
Timberville, VA 22853
Phone (804) 612-3312

NPI Registry JSON

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1245698935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 STAPLES MILL RD",
            "address_2": "STE 102",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232285445",
            "telephone_number": "804-612-3312",
            "fax_number": "804-276-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16056 ELDERLY LN",
            "city": "TIMBERVILLE",
            "state": "VA",
            "postal_code": "228532922",
            "telephone_number": "804-612-3312",
            "fax_number": "804-276-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMER HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "KAMENCIK",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-864-1320"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timberville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.