VCPHCS XIX LLC NPI 1639515646

NPI Information

NPI: 1639515646
Provider Name: VCPHCS XIX, LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 44D2043141

Address:
1869 HIGHWAY 45 BYP
SUITE 5
JACKSON, TN
ZIP 38305
Phone: (731) 660-0880
Get Directions

VCPHCS XIX, LLC is a rehabilitation and substance use disorder clinic center in Jackson, TN. VCPHCS XIX, LLC NPI is 1639515646. The provider is registered as an organization entity type.

The provider's business location address is:

1869 HIGHWAY 45 BYP
SUITE 5
JACKSON, TN
ZIP 38305-464
Phone: (731) 660-0880
Fax: (731) 668-0380

The provider's authorized official is Jemece Michelle Gasaway .
The authorized official title is Director Of Licensing and has the following contact phone number (214) 365-6126.

The CLIA number assigned to this NPI record is 44D2043141 - other - outpatient treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2013 and was last updated on 2/20/2019.

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	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	261QM2800X	Clinic/Center	Methadone	L000000011853	TENNESSEE	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »