NPIMap

Organization Active NPI

Southeastern Psychiatric Management, Inc.

Doing business as Mountain View Residential Program

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Gadsden, AL
National Provider Identifier
1750559084
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.
Doing business as
Mountain View Residential Program
Practice address
3001 Scenic Hwy
Gadsden, AL 35904-3047
Phone
(256) 546-9265
Fax
(256) 549-0376
NPI assigned
Feb 20, 2008
Last updated
Mar 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Joy R Ballenger
Title
Network Manager
Phone
(256) 546-9265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

3001 Scenic Hwy
Gadsden, AL 35904-3047

Mailing address

3001 Scenic Hwy
Gadsden, AL 35904-3047
Phone (256) 546-9265

Other identifiers 1

IdentifierTypeStateIssuer
RTF0013HMedicaidAL

Other names 1

  • Mountain View Residential Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southeastern Psy Mgmtsou5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1750559084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 SCENIC HWY",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359043047",
            "telephone_number": "256-546-9265",
            "fax_number": "256-549-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SCENIC HWY",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359043047",
            "telephone_number": "256-546-9265",
            "fax_number": "256-549-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN PSYCHIATRIC MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "BALLENGER",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "NETWORK MANAGER",
        "authorized_official_telephone_number": "256-546-9265"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RTF0013H",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain View Residential Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.