SRAINTREE VILLAGE (NPI# 1730202219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730202219 |
| Entity Type | Organization |
| Organization Name | SRAINTREE VILLAGE |
| Practice Address |
3757 Johnston Rd Valdosta GA 31601-2105 |
| Practice Telephone | 2295595944 |
| Mailing Telephone | 2295595944 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. EDWARD E SANDERS (ASST. ADMIN.) |
| Authorized Official Telephone | 2295595944 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | CPA-40075 | GA | Residential Treatment Facilities |
| Street Address |
3757 JOHNSTON RD |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31601-2105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578696654 | Gresham Royal Holton | Marriage & Family Therapist | 3757 Johnston Rd, Valdosta, GA 31601-2105 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
| 1508332438 | Euniqua Lashay Williams | Contractor | 812 Lausanne Drive, Valdosta, GA 31601 | 2018-10-18 |
| 1457847634 | Valencia Meshay Johnson | Contractor | 1211 North Oak Street, Valdosta, GA 31601 | 2018-07-10 |
| 1376038042 | Restoration Care Services, LLC | Home Health | 704 Lake Park Road, Valdosta, GA 31601 | 2018-06-26 |
| 1609373133 | Ikea Sharnay Calhoun | Contractor | 1710 Dedo Drive, Valdosta, GA 31601 | 2018-04-11 |
| 1174049431 | Alexious Denson | Contractor | 900 Blanton St., Apt A16, Valdosta, GA 31601 | 2017-08-18 |
| 1578012258 | Clarissa Yolanda Alderman | Counselor | 4107 N Forrest Run Circle, Valdosta, GA 31601 | 2016-09-23 |
| 1225322613 | Andrea J. Ramirez | Counselor | 1301 Melody Ln Ste B, Valdosta, GA 31601 | 2011-06-03 |
| 1316248560 | L&r Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Sharper Circle, Valdosta, GU 31601 | 2010-11-04 |
| 1902121809 | Grace Healthcare Services Inc | Respite Care | 1010 Slater Street, Valdosta, GA 31601 | 2010-04-02 |
| Find all providers in zip 31601 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| 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. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578636817 | South Georgia Csb | Residential Treatment Facility, Emotionally Disturbed Children | 4401 Willow Wood Gate, Valdosta, GA 31602-6709 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023543766 | One Heart and One Mind Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5737 Old National Hwy, Suite 300, Atlanta, GA 30349-7410 | 2017-05-01 |
| 1396131249 | There's No Place Like A Loving Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Jardin Ct, Alpharetta, GA 30022-4600 | 2015-04-07 |
| 1912343302 | Our Spot | Residential Treatment Facility, Emotionally Disturbed Children | 1015 E Inman St, Statesboro, GA 30458-2049 | 2013-05-13 |
| 1902163520 | Shepherd's Hill Academy, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2200 Price Rd, Martin, GA 30557-3457 | 2012-04-20 |
| 1871879312 | Vision Youth Services Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4228 Redan Rd, Stone Mountain, GA 30083-5040 | 2011-10-28 |
| 1356634034 | Soaring Eagle Children's Group | Residential Treatment Facility, Emotionally Disturbed Children | 3183 Northbrook Dr, Atlanta, GA 30341-4629 | 2011-05-27 |
| 1124330386 | Favorable Network Solutions | Residential Treatment Facility, Emotionally Disturbed Children | 881 Memorial Dr Se, Suite 213, Atlanta, GA 30316-1270 | 2010-07-04 |
| 1467687665 | Positive Impact Hhs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 934 Garden Walk Blvd. # 903, College Park, GA 30349-8508 | 2009-05-18 |
| 1932342235 | The Sanctuary House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 500 John Deere Rd Nw, Monroe, GA 30656-4769 | 2009-04-16 |
| 1417198458 | Naciema Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Stone Rd Sw Apt W8, Atlanta, GA 30331-2920 | 2009-03-22 |
| 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.