FREE WILL BAPTIST FAMILY MINISTRIES, INC. (NPI# 1538269915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538269915 |
| Entity Type | Organization |
| Organization Name | FREE WILL BAPTIST FAMILY MINISTRIES, INC. |
| Other Organization Name | BRISTOL BOYS HOME |
| Practice Address |
15149 Old Jonesboro Road Bristol VA 24202-4623 |
| Mailing Address |
90 Stanley Lane Greeneville TN 37743 |
| Practice Telephone | 2764665051 |
| Practice Fax Number | 2764665045 |
| Mailing Telephone | 4236399449 |
| Mailing Fax Number | 4236395083 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAMES KILGORE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4236399449 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | SS-304-06 | VA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Bristol Boys Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023394186 | Free Will Baptist Family Ministries, Inc. | Substance Abuse Rehabilitation Facility | 90 Stanley Ln, Greeneville, TN 37743-6066 | 2011-11-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporation | Free Will Baptist Family Ministries, Inc. | 90 Stanley Lane , Greenville, TN 37743 |
| Virginia Business Entity | FREE WILL BAPTIST FAMILY MINISTRIES, INC. | 90 STANLEY LANE , GREENEVILLE, TN 37743 |
| Street Address |
15149 OLD JONESBORO ROAD |
| City | BRISTOL |
| State | VA |
| Zip Code | 24202-4623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568977940 | Renaissance Medical Care | Family Medicine | 284 Blevins Boulevard, Bristol, VA 24202 | 2017-12-07 |
| 1467725879 | Leighton W Wood Dds Ms P.C. | Dentist | 103 Linden Square Drive, Bristol, VA 24202 | 2012-02-15 |
| 1285828640 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 13249 Lee Highway, Bristol, VA 24202 | 2007-08-29 |
| 1154462117 | Emdee Clinica, Pllc | Clinic/Center | 23164 Kestrel Dr, Bristol, VA 24202 | 2007-02-10 |
| 1053355859 | Commonweatlh of Virginia State Board of Health | Public Health or Welfare | 15068 Lee Highway, Suite 1000, Bristol, VA 24202 | 2006-06-15 |
| 1891775193 | William Daryl Wilson | Dentist | 15068 Lee Hwy, Ste 1000 Washington Co Health Dept, Bristol, VA 24202 | 2006-01-20 |
| 1457832123 | Justin Scott Pennington | Physical Therapist | 136 Bristol East Rd, Bristol, VA 24202 | 2018-08-22 |
| 1588104335 | Timothy G. Mcgarry, Md, Pllc | Orthopaedic Surgery | 21371 Forsythe Rd, Bristol, VA 24202 | 2017-02-27 |
| 1669532560 | Washington Co Health Dept Dental Clinic | Dentist | 15068 Lee Highway, Suite 1000, Bristol, VA 24202 | 2006-12-11 |
| 1437568946 | Family Preservation Services, Inc | Community/Behavioral Health | 7741 Rich Valley Rd, Bristol, VA 24202-0439 | 2014-08-08 |
| Find all providers in zip 24202 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982879474 | Adec Inc | Community Based Residential Treatment Facility, Mental Illness | 19670 State Road 120, Bristol, IN 46507-0398 | 2008-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487901 | River City Residential Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 2106 Hungary Rd, Richmond, VA 23228-2208 | 2020-04-27 |
| 1376178079 | Scott's Rehabilitative House | Community Based Residential Treatment Facility, Mental Illness | 104 Country Club Rd, Franklin, VA 23851-2983 | 2020-03-03 |
| 1386298354 | Quality Care Counseling Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 18511 Rollingside Dr, South Chesterfield, VA 23834-1699 | 2019-07-29 |
| 1730690694 | Families United, LLC | Community Based Residential Treatment Facility, Mental Illness | 1801 Hayward Ave, Chesapeake, VA 23320-2231 | 2017-10-18 |
| 1427419035 | Powerhouse Unlimited | Community Based Residential Treatment Facility, Mental Illness | 418 N 25th St, Apt 260, Richmond, VA 23223-7564 | 2016-03-09 |
| 1700266277 | Jan's Residential Homes | Community Based Residential Treatment Facility, Mental Illness | 307 N High St, Blackstone, VA 23824-1421 | 2015-05-31 |
| 1225426083 | Divine Health Support LLC | Community Based Residential Treatment Facility, Mental Illness | 2050 Hanson Ln, Woodbridge, VA 22191-4545 | 2015-01-02 |
| 1063838126 | New Lifestyles, Inc | Community Based Residential Treatment Facility, Mental Illness | 230 W Boscawen St, Winchester, VA 22601-4118 | 2014-03-13 |
| 1053742049 | Pathways Youth Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1010 Marions Trl, Halifax, VA 24558-3126 | 2013-12-02 |
| 1679905269 | Rest Haven LLC | Community Based Residential Treatment Facility, Mental Illness | 1005 Bland St, Norfolk, VA 23513-3386 | 2013-08-06 |
| Find all providers with the same taxonomy | ||||
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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.