NPIMap

Organization Active NPI

Virginia Commonwealth University Health System Authority

Doing business as VTCC-Residental Treatment

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Richmond, VA
National Provider Identifier
1275690976
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
H1875 Issued in VA
Legal business name
VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY
Doing business as
VTCC-Residental Treatment
Practice address
1308 Sherwood Ave
Richmond, VA 23220
Phone
(804) 628-6643
Fax
(804) 828-2029
NPI assigned
Jan 2, 2007
Last updated
Jun 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Melinda S Hancock
Title
Cfo
Phone
(804) 212-5145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X H1875 VA Primary

Addresses

Primary practice location

1308 Sherwood Ave
Richmond, VA 23220

Mailing address

PO Box 758997
Baltimore, MD 21275-0001

Other identifiers 1

IdentifierTypeStateIssuer
207063MedicaidVA

Other names 1

  • VTCC-Residental Treatment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vcu Health System Autho35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Locations

1308 Sherwood Ave
Richmond, VA 23220
Phone (804) 828-3129

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1275690976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 758997",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212750001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 SHERWOOD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23220",
            "telephone_number": "804-628-6643",
            "fax_number": "804-828-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-212-5145"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "VA",
            "license": "H1875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207063",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VTCC-Residental Treatment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VTCC-Residental Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 11, 2018; 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.