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MBHS OF KENBRIDGE LLC NPI 1972940880

NPI Profile

NPI: 1972940880

Provider Name: MBHS OF KENBRIDGE, LLC

Doing Business As: KENBRIDGE YOUTH ACADEMY

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

Entity Type: Organization

Address:
231 HICKORY RD
KENBRIDGE, VA
ZIP 23944

Phone: (454) 676-1378

MBHS OF KENBRIDGE, LLC is a residential treatment facility emotionally disturbed children in Kenbridge, VA. The provider is a provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. MBHS OF KENBRIDGE, LLC NPI is 1972940880. The provider is registered as an organization entity type.
The provider Is Doing Business As Kenbridge Youth Academy.

The provider's business location address is:

231 HICKORY RD
KENBRIDGE, VA
ZIP 23944-503
Phone: (454) 676-1378

The provider's authorized official is Patricia Hamilton .
The authorized official title is Chief Administrative Officer and has the following contact phone number (454) 676-1378.

The enumeration date for this NPI number is 5/31/2013 and was last updated on 6/6/2013.

Map - Location of Practice

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QM0855X Clinic/Center Adolescent and Children Mental Health 2139 VIRGINIA No
2 322D00000X Residential Treatment Facility, Emotionally Disturbed Children 2136-14-001 VIRGINIA Yes

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: 10/8/2017