MBHS of Kenbridge, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

2136-14-001 Issued in VA

Legal business name

MBHS OF KENBRIDGE, LLC

Doing business as

Kenbridge Youth Academy

Practice address

231 Hickory Rd
Kenbridge, VA 23944-3503

Phone

(454) 676-1378

NPI assigned

May 31, 2013

Last updated

Jun 6, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

MERIDIAN BEHAVIORAL HEALTH SYSTEMSAs reported in NPPES

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

Authorized official

Name

Patricia Hamilton

Title

Chief Administrative Officer

Phone

(454) 676-1378

Specialties & licenses 2

Addresses

Other names 1

• Kenbridge Youth Academy Doing business as

Locations

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.

• Kevin Witty, R.N.

  • Child & Adolescent Psychiatric/Mental Health Registered Nurse
  • Kenbridge, VA
  • NPI 1821428699
  NPD (past)

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

{
    "created_epoch": "1369958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1972940880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 HICKORY RD",
            "city": "KENBRIDGE",
            "state": "VA",
            "postal_code": "239443503",
            "telephone_number": "454-676-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 HICKORY RD",
            "city": "KENBRIDGE",
            "state": "VA",
            "postal_code": "239443503",
            "telephone_number": "454-676-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBHS OF KENBRIDGE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERIDIAN BEHAVIORAL HEALTH SYSTEMS",
        "enumeration_date": "2013-05-31",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "454-676-1378"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "VA",
            "license": "2139",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "VA",
            "license": "2136-14-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenbridge Youth Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carroll Millard Gee Jr., DDS
• Kenbridge Emergency Squad, Inc.
• Kenbridge Family Medicine Inc
• Kenbridge Family Medicine Inc
• Sharon Brown Lyles, ED.D.
• David W Michie, MD
• Angela Charlene Moss, RN,BSN,QMHP
• Nocturnal Science and Sound Temple
• Patience Transportation LLC (non medical transport provider)
• Rebecca Reitz

• Emotionally Disturbed Childrens' Residential Treatment Facility in Kenbridge, VA
• Providers in Kenbridge, VA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.