Jefferson Trail Treatment Center for Children

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

63014001 Issued in VA

Legal business name

JEFFERSON TRAIL TREATMENT CENTER FOR CHILDREN

Practice address

2101 Arlington Blvd
Charlottesville, VA 22903-1521

Phone

(615) 250-0283

Fax

(615) 250-0000

NPI assigned

Jun 30, 2011

Last updated

Jun 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vicki Tench, BOD

Title

Business Office Director

Phone

(615) 250-0283

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Jefferson Trail Treatment Center for Children2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Jefferson Trail Treatment Center for Children

  • Psychiatric Hospital
  • Charlottesville, VA
  • NPI 1740245117
  NPD tax ID

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309392000000",
    "number": "1922395748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WESTWOOD PL",
            "address_2": "SUITE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275075",
            "telephone_number": "615-250-0283",
            "fax_number": "615-250-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 ARLINGTON BLVD",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229031521",
            "telephone_number": "615-250-0283",
            "fax_number": "615-250-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON TRAIL TREATMENT CENTER FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-30",
        "last_updated": "2011-06-30",
        "status": "A",
        "authorized_official_last_name": "TENCH",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "BUSINESS OFFICE DIRECTOR",
        "authorized_official_telephone_number": "615-250-0283",
        "authorized_official_credential": "BOD"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "VA",
            "license": "63014001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000207306",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jefferson Cardiovascular Associates
• Jefferson Nephrology, LTD
• Jefferson OB GYN LTD
• Jefferson OB GYN LTD
• Jefferson Trail Treatment Center for Children
• Natalie Jefferson, APN
• Jeffery E. Hodges DDS PC (Albemarle Dental Associates)
• Jeffery E. Hodges DDS PC (Albemarle Dental Associates)
• Martin David Jeffries, M.D.
• Alan D. Jenkins, M.D.

• Psychiatric Residential Treatment Facility in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Psychiatric Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; 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.