NPIMap

Organization Active NPI

Keystone Continuum, LLC

Doing business as Natchez Trace Youth Academy

  • Psychiatric Residential Treatment Facility
  • Waverly, TN
National Provider Identifier
1902825151
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
SO09869A Issued in TN
Legal business name
KEYSTONE CONTINUUM, LLC
Doing business as
Natchez Trace Youth Academy
Practice address
415 Seven Hawks LN
Waverly, TN 37185-2536
Phone
(931) 296-1183
Fax
(931) 296-7576
NPI assigned
Jul 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tom Hennessey
Title
Administrator
Phone
(931) 296-1183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X SO09869A TN Primary

Addresses

Primary practice location

415 Seven Hawks LN
Waverly, TN 37185-2536

Mailing address

415 Seven Hawks LN
Waverly, TN 37185-2536
Phone (931) 296-1183

Other names 1

  • Natchez Trace Youth Academy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2046271Natchez Trace Youth Academy415 Seven Hawks LN, Waverly, TN 37185Certificate of waiverAug 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Keystone Continuum LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

415 Seven Hawks Ln
Waverly, TN 37185
Phone (931) 296-1183

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": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902825151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SEVEN HAWKS LN",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371852536",
            "telephone_number": "931-296-1183",
            "fax_number": "931-296-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SEVEN HAWKS LN",
            "city": "WAVERLY",
            "state": "TN",
            "postal_code": "371852536",
            "telephone_number": "931-296-1183",
            "fax_number": "931-296-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE CONTINUUM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENNESSEY",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "931-296-1183"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TN",
            "license": "SO09869A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natchez Trace Youth Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.