Hamlet House Youth Services, III LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

1347-14-001 Issued in VA

Legal business name

HAMLET HOUSE YOUTH SERVICES, III LLC

Practice address

206 Carlstone Dr
Highland Springs, VA 23075-2503

Phone

(804) 326-9046

Fax

(804) 326-9046

NPI assigned

Aug 28, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Gwendolyn Scurlock Ingram

Title

Chief Administrative Office

Phone

(804) 326-9046

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1366790107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 CLAUSON RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271203",
            "telephone_number": "804-326-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CARLSTONE DR",
            "city": "HIGHLAND SPRINGS",
            "state": "VA",
            "postal_code": "230752503",
            "telephone_number": "804-326-9046",
            "fax_number": "804-326-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMLET HOUSE YOUTH SERVICES, III LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "SCURLOCK",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICE",
        "authorized_official_telephone_number": "804-326-9046",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "1347-14-001",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "VA",
            "license": "1347-14-001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Highland Springs, VA
• Providers in Highland Springs, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.