Madam Patricia Children Foundation

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

MADAM PATRICIA CHILDREN FOUNDATION

Practice address

734 W Locust St
Johnson City, TN 37604-6504

Phone

(703) 814-6748

Fax

(571) 441-0861

NPI assigned

Jun 8, 2024

Organization subpart

No

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

Authorized official

Name

Rev Leonard Chukwujioke-Mbiha, CCMA MHA

Title

Healthcare Administrator

Phone

(703) 814-6748

Specialties & licenses 11

Addresses

Other names 1

• HANDS OF CARE ANGELS Doing business as

Locations

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

{
    "created_epoch": "1717804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717804800000",
    "number": "1992547277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 BLUE RIDGE AVE",
            "city": "FRONT ROYAL",
            "state": "VA",
            "postal_code": "226303005",
            "telephone_number": "703-814-6748",
            "fax_number": "571-441-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 W LOCUST ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046504",
            "telephone_number": "703-814-6748",
            "fax_number": "571-441-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADAM PATRICIA CHILDREN FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-08",
        "last_updated": "2024-06-08",
        "certification_date": "2024-06-08",
        "status": "A",
        "authorized_official_last_name": "CHUKWUJIOKE-MBIHA",
        "authorized_official_first_name": "REV LEONARD",
        "authorized_official_title_or_position": "HEALTHCARE ADMINISTRATOR",
        "authorized_official_telephone_number": "703-814-6748",
        "authorized_official_credential": "CCMA MHA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HANDS OF CARE ANGELS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamal Gerges Maatouk, MD
• Michael R Mabry, DO
• Yolanda Mabry, APN
• Demetrio Rebano Macariola Jr., MD
• Scott R Macdonald, DO
• Ashish B Madhok, MD
• Jonathan Madill, D.C.
• Marquita Leonna Renee Madison
• Hezborn Magacha, MD
• John Kyrillos Magdi Kamal Magar, M.D.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2024; 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.