NPIMap

Organization Active NPI

Southern Support Behavioral Health Care LLC

  • Community/Behavioral Health Agency
  • North Chesterfield, VA
National Provider Identifier
1346000320
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SOUTHERN SUPPORT BEHAVIORAL HEALTH CARE LLC
Practice address
9840 Midlothian Tpke Ste J
North Chesterfield, VA 23235-4864
Phone
(252) 209-7896
Fax
(877) 225-6011
NPI assigned
Mar 19, 2024
Last updated
Mar 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN SUPPORT BEHAVIORAL HEALTH CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Vickie M PersaudNPI 1174042907
Title
Owner
Phone
(252) 642-5345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

9840 Midlothian Tpke Ste J
North Chesterfield, VA 23235-4864

Mailing address

PO Box 134
Colerain, NC 27924-0134

Other names 1

  • Select Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Southern Support Behavioral Health Care LLC3 organizations share this tax ID, including this one
Part of
Southern Support Behavioral Health Care LLC

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1346000320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 134",
            "city": "COLERAIN",
            "state": "NC",
            "postal_code": "279240134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 MIDLOTHIAN TPKE STE J",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354864",
            "telephone_number": "252-209-7896",
            "fax_number": "877-225-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SUPPORT BEHAVIORAL HEALTH CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN SUPPORT BEHAVIORAL HEALTH CARE LLC",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "PERSAUD",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-642-5345"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 19, 2024; 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.