Staunton Treatment Center, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

STAUNTON TREATMENT CENTER, LLC

Practice address

15 Green Hills Drive
Staunton, VA 24401

Phone

(540) 217-6366

NPI assigned

Aug 30, 2017

Organization subpart

No

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

Authorized official

Name

Jay Higham

Title

Ceo

Phone

(214) 365-6100

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig W Swainey, MD

  • Child & Adolescent Psychiatry Physician
  • Richmond, VA
  • NPI 1437367414
  NPD
• Julian S Ku, M.D.

  • General Practice Physician
  • Norfolk, VA
  • NPI 1922386291
  NPD (past)
• Stephanie L Peglow, DO

  • Psychiatry Physician
  • Hampton, VA
  • NPI 1225354426
  NPD (past)
• Mary Rose Tidoe, APRN

  • Family Nurse Practitioner
  • Danville, VA
  • NPI 1073142881
  NPD (past)
• Kenneth Brown, MD

  • Emergency Medicine Physician
  • Cherry Hill, NJ
  • NPI 1164521084
  NPD (past)

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1942728985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY RD STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "540-217-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GREEN HILLS DRIVE",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "24401",
            "telephone_number": "540-217-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAUNTON TREATMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6100"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staunton City Public Schools
• Staunton Eye Clinic PLC
• Staunton Eye Clinic PLC
• Staunton Medical Associates, Inc.
• Staunton SNF Operations LLC
• Anthony Arthur Steele, MD
• James Walker Steffey II, PHARMD
• Stevan T Hanna MD LTD
• James R Stewart, M.D.
• Lauren Stiles

• All providers in Staunton, VA
• Substance Use Disorder Rehabilitation Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.