Active NPI
Otl Community Services
- Community/Behavioral Health Agency
- North Chesterfield, VA
National Provider Identifier
1295863090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- OTL COMMUNITY SERVICES
- Practice address
- 9201 Arboretum Pkwy Ste 300
North Chesterfield, VA 23236-5407 - Phone
- (855) 355-7001
- Fax
- (804) 251-0989
- NPI assigned
- Mar 1, 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
- Hailey Mazzei
- Title
- Program Director
- Phone
- (804) 520-4600
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | 74805001 | VA | |
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
9201 Arboretum Pkwy Ste 300
North Chesterfield, VA 23236-5407
Mailing address
9201 Arboretum Pkwy Ste 300
North Chesterfield, VA 23236-5407
Phone (804) 520-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74805001 | Other | VA | DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES |
Other names 1
- Good Neighbor Intensive In Home Services, Inc.
National Provider Directory
National Provider DirectoryLocations
798 Southpark Blvd
Ste 16
Colonial Heights, VA 23834
Phone (215) 668-9418
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Counselor
- Lynchburg, VA
- NPI 1316569106
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684886400000",
"number": "1295863090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9201 ARBORETUM PKWY STE 300",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232365407",
"telephone_number": "804-520-4600",
"fax_number": "833-525-0063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9201 ARBORETUM PKWY STE 300",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232365407",
"telephone_number": "855-355-7001",
"fax_number": "804-251-0989"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OTL COMMUNITY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-01",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A",
"authorized_official_last_name": "MAZZEI",
"authorized_official_first_name": "HAILEY",
"authorized_official_title_or_position": "PROGRAM DIRECTOR",
"authorized_official_telephone_number": "804-520-4600"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "VA",
"license": "74805001",
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES",
"identifier": "74805001",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Good Neighbor Intensive In Home Services, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in North Chesterfield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.