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JAMES BENTLEY TREATMENT PROGRAM NPI 1093040214


NPI Information

NPI: 1093040214
Provider Name: JAMES BENTLEY TREATMENT PROGRAM

Doing Business As: HAVEN HOUSE FOR GIRLS

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
1020 LECKIE STREET
PORTSMOUTH, VA
ZIP 23704
Phone: (757) 399-4742
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JAMES BENTLEY TREATMENT PROGRAM is a community based residential treatment facility mental illness in Portsmouth, VA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. JAMES BENTLEY TREATMENT PROGRAM NPI is 1093040214. The provider is registered as an organization entity type.
The provider Is Doing Business As Haven House For Girls.

The provider's business location address is:

1020 LECKIE STREET
PORTSMOUTH, VA
ZIP 23704
Phone: (757) 399-4742
Fax: (757) 675-7965

The provider's authorized official is Sandra Pinnock .
The authorized official title is Director and has the following contact phone number (757) 399-4742.

The enumeration date for this NPI number is 10/6/2009 and was last updated on 10/6/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental Illness78214002VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
178214002MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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