VCPHCS XIX, LLC (NPI# 1639515646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639515646 |
| Entity Type | Organization |
| Organization Name | VCPHCS XIX, LLC |
| Practice Address |
1869 Highway 45 Byp Suite 5 Jackson TN 38305-2464 |
| Mailing Address |
5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 |
| Practice Telephone | 7316600880 |
| Practice Fax Number | 7316680380 |
| Mailing Telephone | 2143656100 |
| Mailing Fax Number | 2143656150 |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2019-02-20 |
| Authorized Official Name | JEMECE MICHELLE GASAWAY (DIRECTOR OF LICENSING) |
| Authorized Official Telephone | 2143656126 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
L000000011853 | TN | Ambulatory Health Care Facilities |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
1869 HIGHWAY 45 BYP SUITE 5 |
| City | JACKSON |
| State | TN |
| Zip Code | 38305-2464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871752105 | Raleigh Professional Associates | Clinic/Center | 1869 Highway 45 Byp, Suite 5, Jackson, TN 38305-2464 | 2008-06-02 |
| 1225462088 | Traci Robinson | Licensed Practical Nurse | 1869 Highway 45 Byp, Suite 5, Jackson, TN 38305-2464 | 2013-08-29 |
| 1265866024 | Gloretta Dianna Turner | Licensed Practical Nurse | 1869 Highway 45 Byp, Jackson, TN 38305-2464 | 2013-08-29 |
| 1689008401 | Carolyn Ann Thomas | Licensed Practical Nurse | 1869 Highway 45 Byp, Suite 5, Jackson, TN 38305-2464 | 2013-08-28 |
| 1588964811 | Good Samaritan Family Walk-in Clinic, LLC | Clinic/Center | 1869 Highway 45 Byp, Suite 4, Jackson, TN 38305-2464 | 2010-11-03 |
| 1447496435 | Harnisch Wellness Clinic Inc | Clinic/Center | 1869 Highway 45 Byp, Suite 2b, Jackson, TN 38305-2464 | 2008-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656818 | Kimaya Jelks | Specialist | 1869 45 Hwy Bypass, Suite 2b, Jackson, TN 38305 | 2020-10-16 |
| 1821600578 | Maame Obeng | Pharmacist | 3144 North Highland Avenue, Jackson, TN 38305 | 2020-08-22 |
| 1700361904 | James Cowie | Psychologist | 156c West University Pkwy, Jackson, TN 38305 | 2018-10-03 |
| 1700372109 | Chad Zawacki | Physician Assistant | 147 North Star Drive, Jackson, TN 38305 | 2018-07-09 |
| 1104323070 | Golden Years Adult Day Care | Clinic/Center | 155 Carriage Dr Suite A, Jackson, TN 38305 | 2018-04-09 |
| 1245754563 | Tanika Annette Gillard | Massage Therapist | 4 Hampton Ln, Jackson, TN 38305 | 2017-07-28 |
| 1316488117 | Lakisha T Ingram | Counselor | 168 Greencastle Dr, Jackson, TN 38305 | 2017-03-13 |
| 1619421567 | D & L Wellness Inc | Community/Behavioral Health | 154 Carriage House Dr., Jackson, TN 38305 | 2016-08-09 |
| 1649637638 | Advance Choice Home Care LLC | In Home Supportive Care | 1028 Ashport Rd., Jackson, TN 38305 | 2016-01-21 |
| 1942666151 | Neurohealth Solutions Inc. | Clinic/Center | 174 Murray Guard Dr. Suite E, Jackson, TN 38305 | 2016-01-05 |
| Find all providers in zip 38305 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093210551 | W. A. Foote Memorial Hospital, Inc | Clinic/Center | 2424 W Washington Ave Ste 100, Jackson, MI 49203-1236 | 2018-03-27 |
| 1821248279 | Alternatives for Life Treatment & Recovery of Jackson LLC | Clinic/Center | 500d E Woodrow Wilson Ave, Jackson, MS 39216-4538 | 2008-09-23 |
| 1588868707 | Curran Seeley Foundation | Clinic/Center | 610 W. Broadway, Suite L1, Jackson, WY 83001 | 2007-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850708 | Crossroads Treatment Centers of Tennessee, PC | Clinic/Center | 114 Perkins Ln, Jacksboro, TN 37757-2833 | 2020-07-31 |
| 1477161982 | Addiction Behavioral Care | Clinic/Center | 2617 Grandview Ave Ste 103, Nashville, TN 37211-2263 | 2020-07-21 |
| 1841808342 | Nashville Addiction Clinic | Clinic/Center | 5515 Edmondson Pike Ste 118, Nashville, TN 37211-5871 | 2020-07-21 |
| 1043828668 | Chattanooga Recovery Center LLC | Clinic/Center | 13 W Kent St Ste 201, Chattanooga, TN 37405-9913 | 2020-07-20 |
| 1588296131 | Integrative Health Centers LLC | Clinic/Center | 1105 16th Ave S Ste C, Nashville, TN 37212-2327 | 2020-02-11 |
| 1912465121 | Applegate Health Services of Tennessee, Inc | Clinic/Center | 446 Metroplex Dr Ste 200a, Nashville, TN 37211-3139 | 2019-03-06 |
| 1295204022 | Harpeth Recovery Clinic | Clinic/Center | 3011 Harrah Dr Ste T, Spring Hill, TN 37174-6254 | 2018-11-22 |
| 1861984353 | The Transition House of Tennessee, Inc. | Clinic/Center | 1024 E Mlk, Chattanooga, TN 37403-2710 | 2018-05-31 |
| 1265923775 | Wake Up Well Recovery LLC | Clinic/Center | 211 Donelson Pike Ste 108, Nashville, TN 37214-2929 | 2018-05-21 |
| 1275049215 | Holston Health Associates, Pllc | Clinic/Center | 249 E Main St Ste A, Johnson City, TN 37604-5707 | 2017-12-27 |
| 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.