NPIMap

Organization Active NPI

Atiba Youth Intervention Services/Danville LLC

  • Exclusive Provider Organization
  • Danville, VA
National Provider Identifier
1376879411
Registry record updated Oct 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
118105001 Issued in VA
Legal business name
ATIBA YOUTH INTERVENTION SERVICES/DANVILLE LLC
Practice address
3401 Westover Dr Ste a
Danville, VA 24541-5469
Phone
(434) 822-0084
Fax
(434) 822-0086
NPI assigned
Oct 25, 2009
Last updated
Oct 25, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
ATIBA YOUTH INTERVENTION SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2009

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

Authorized official

Name
Mr. Donald Anthony Wheeler
Title
Executive Director
Phone
(804) 272-2277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 118105001 VA Primary

Addresses

Primary practice location

3401 Westover Dr Ste a
Danville, VA 24541-5469

Mailing address

7825 Midlothian Tpke Ste 112
Richmond, VA 23235-5247
Phone (804) 272-2277

National Provider Directory

National Provider Directory
Tax ID family
Atiba Youth Intervention Services-Danville LLC2 organizations share this tax ID, including this one
Part of
Atiba Youth Intervention Servicse

Other organizations with this tax ID 1

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

Locations

3401 Westover Dr
Ste A
Danville, VA 24541
Phone (434) 822-0084

7825 Midlothian Tpke
Ste 112
North Chesterfield, VA 23235
Phone (804) 272-2277

NPI Registry JSON

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

{
    "created_epoch": "1256428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256428800000",
    "number": "1376879411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7825 MIDLOTHIAN TPKE STE 112",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232355247",
            "telephone_number": "804-272-2277",
            "fax_number": "804-272-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 WESTOVER DR STE A",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245415469",
            "telephone_number": "434-822-0084",
            "fax_number": "434-822-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATIBA YOUTH INTERVENTION SERVICES/DANVILLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATIBA YOUTH INTERVENTION SERVICES LLC",
        "enumeration_date": "2009-10-25",
        "last_updated": "2009-10-25",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-272-2277",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "VA",
            "license": "118105001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2009; 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.