SECOND NATURE BLUE RIDGE, LLC (NPI# 1427562750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427562750 |
Entity Type | Organization |
Organization Name | SECOND NATURE BLUE RIDGE, LLC |
Other Organization Name | DBA BLUE RIDGE THERAPEUTIC WILDERNESS |
Practice Address |
236 File St. Clayton GA 30525 |
Mailing Address |
Po Box 809 Clayton GA 30525 |
Practice Telephone | 7062122037 |
Practice Fax Number | 7062120354 |
Mailing Telephone | 7062122037 |
Mailing Fax Number | 7062120354 |
Enumeration Date | 2017-11-22 |
Last Update Date | 2017-11-22 |
Authorized Official Name | VANESSA ALLEN (DIRECTOR OF OPERATIONS) |
Authorized Official Telephone | 7062122037 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 323P00000X | Psychiatric Residential Treatment Facility | 50017-RCC | GA | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
DBA Blue Ridge Therapeutic Wilderness | Doing Business As Name - Organization |
Street Address |
236 FILE ST. |
City | CLAYTON |
State | GA |
Zip Code | 30525 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528605839 | Charlotte Hart Fandrich | Massage Therapist | 1048 Old Highway 441 North, Clayton, GA 30525 | 2019-12-05 |
1922577147 | Suzanne A Frederickson | Speech-Language Pathologist | Highlands Internal Medicine, PC, 156 North Main St, Clayton, GA 30525 | 2018-11-16 |
1053854752 | Haley Vaughan Stapleton | Nurse Practitioner | 596 Mountain City Road, Clayton, GA 30525 | 2016-11-29 |
1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
1316239122 | Jason A Bonner | Pharmacist | 1455 U.S. 441, Clayton, GA 30525 | 2011-05-11 |
1477842557 | Clayton Therapy Center, LLC | Marriage & Family Therapist | 24 Chechero St, Suite 2, Clayton, GA 30525 | 2011-03-29 |
1891959672 | Adams Hearing Aid Specialists | Hearing Instrument Specialist | 91 E Savannah Place, Clayton, GA 30525 | 2008-07-11 |
1578721494 | Lawrence M Gillespie | Dentist | 436 Warwoman Road, Clayton, GA 30525 | 2008-05-28 |
1336262112 | Clayton Family Eye Care PC | Optometrist | 50 Earl St., Suite A, Clayton, GA 30525 | 2007-04-09 |
1932220266 | Mountain Physical Therapy Inc | Physical Therapist | 1218 North Main St, Clayton, GA 30525 | 2007-04-03 |
Find all providers in zip 30525 |
Taxonomy Code | 323P00000X |
Grouping | Residential Treatment Facilities |
Classification | Psychiatric Residential Treatment Facility |
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952925190 | Nvw Newco LLC | Psychiatric Residential Treatment Facility | 311 North Main Street, Clayton, GA 30525 | 2020-06-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811530645 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 3390 Peachtree Rd Ne Ste 1150, Atlanta, GA 30326-2821 | 2019-10-24 |
1134694524 | Rep Perimeter Holdings, LLC | Psychiatric Residential Treatment Facility | 2520 Northwinds Pkwy Ste 550, Alpharetta, GA 30009-2236 | 2018-10-11 |
1831633759 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 1364 Manget Way, Atlanta, GA 30338-4810 | 2016-12-12 |
1083987234 | Naja Personal Care, Inc. | Psychiatric Residential Treatment Facility | 935 Donington Cir, Lawrenceville, GA 30045-3581 | 2012-02-20 |
1932472180 | Royal Cottage Inc | Psychiatric Residential Treatment Facility | 65 Stoney Point Ter, Covington, GA 30014-7070 | 2012-02-20 |
1033482369 | A Place for Comfort LLC | Psychiatric Residential Treatment Facility | 1766 Big Valley Ln, Stone Mountain, GA 30083-5712 | 2012-02-16 |
1346512555 | Praying Hands Incorporated | Psychiatric Residential Treatment Facility | 1385 Harris Rd, Lawrenceville, GA 30043-3910 | 2012-02-02 |
1730475799 | Onyi Agnes Chimaobi | Psychiatric Residential Treatment Facility | 2326 Magaw Ln, Powder Springs, GA 30127-5629 | 2011-06-28 |
1407158231 | Mcknight Personal Care Home Inc | Psychiatric Residential Treatment Facility | 3045 Carriage Trl, Jonesboro, GA 30236-6835 | 2010-11-30 |
1588861876 | Ramsay Youth Services of Georgia | Psychiatric Residential Treatment Facility | 3500 Riverside Drive, Macon, GA 31210-0000 | 2007-06-29 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.