T'Lab, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

38214035 Issued in VA

Legal business name

T'LAB, INC.

Practice address

823 S Jones St
Petersburg, VA 23803-4952

Phone

(804) 590-2227

Fax

(804) 451-9573

NPI assigned

Jan 13, 2016

Organization subpart

No

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

Authorized official

Name

Janine Johnson

Title

Executive Director

Phone

(804) 721-6861

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1679939169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 W AUTUMN DR",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238038433",
            "telephone_number": "804-721-6861",
            "fax_number": "804-451-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 S JONES ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034952",
            "telephone_number": "804-590-2227",
            "fax_number": "804-451-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T'LAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JANINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-721-6861"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "38214035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.