Camp Wanna Be

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CAMP WANNA BE

Practice address

582 Mel Blount Rd
Vidalia, GA 30474-9714

Phone

(912) 537-7787

NPI assigned

Aug 3, 2012

Last updated

Aug 3, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

ALICE BLOUNT ACADEMY OF SCIENCE AND AGRICULTUREAs reported in NPPES

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

Authorized official

Name

Mr. Clinton Blount

Title

Director

Phone

(912) 537-7787

Specialties & licenses 7

Addresses

Tax ID family

Twin Oaks2 organizations share this tax ID, including this one

Part of

Twin Oaks

Other organizations with this tax ID 1

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

• Twin Oaks

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Vidalia, GA
  • NPI 1285870691
  NPD tax ID

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1306192737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 MEL BLOUNT RD",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304749714",
            "telephone_number": "912-537-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 MEL BLOUNT RD",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304749714",
            "telephone_number": "912-537-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMP WANNA BE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALICE BLOUNT ACADEMY OF SCIENCE AND AGRICULTURE",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "BLOUNT",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "912-537-7787",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glen Jason Bunn Jr., MD
• Albert A Burton, M.D.
• Buysmart RX-HME Inc (BuySmart Rx/Hme)
• Patrick J. Byrne, MD
• Carolyn Cabe
• James William Campbell III, FNP-C
• Cardiology Associates of Vidalia, P.C.
• Dustin J Carter, MPAS, PA-C
• Wilton Todd Carter
• Brenna Casey, DO

• Professional Counselor in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.