WILLIAMSVILLE WELLNESS PHP (NPI# 1871965301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871965301 |
| Entity Type | Organization |
| Organization Name | WILLIAMSVILLE WELLNESS PHP |
| Other Organization Name | WILLIAMSVILLE WELLNESS CENTER |
| Practice Address |
10515 Cabaniss Ln Hanover VA 23069-1840 |
| Practice Telephone | 8045599959 |
| Practice Fax Number | 8045599613 |
| Mailing Telephone | 8045599959 |
| Mailing Fax Number | 8045599613 |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2015-10-23 |
| Authorized Official Name | MR. ROBERT WOODROW CABANISS JR. (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8045599959 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLIAMSVILLE WELLNESS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 994 | VA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | NPI WILLIAMSVILLE WELLNESS IOP | 1376941203 | 01 |
| VA | NPI | 1477704708 | 01 |
| Other Name | Type Code |
|---|---|
| Williamsville Wellness Center | Other Name - Individual/Organization |
| Street Address |
10515 CABANISS LN |
| City | HANOVER |
| State | VA |
| Zip Code | 23069-1840 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477704708 | Williamsville Wellness LLC | Substance Abuse Rehabilitation Facility | 10515 Cabaniss Ln, Hanover, VA 23069-1840 | 2008-10-06 |
| 1821574575 | Todd Charles Stonnell | Counselor | 10515 Cabaniss Ln, Hanover, VA 23069-1840 | 2018-07-16 |
| 1376861617 | Lyndon J. Aguiar | Psychologist | 10515 Cabaniss Ln, Hanover, VA 23069-1840 | 2010-05-11 |
| 1710121868 | Stephen R Adams | Counselor | 10515 Cabaniss Ln, Hanover, VA 23069-1840 | 2009-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801219332 | Rural Plains Emergency Physicians LLC | Emergency Medicine | 9275 Chamberlayne Road, Mechanicasville, VA 23069 | 2014-02-04 |
| 1245275403 | Hanover County Board of Supervisors | Ambulance | 13326 Hanover Courthouse Road, Hanover, VA 23069 | 2006-06-19 |
| 1063832293 | Loon Emergency Physicians LLC | Emergency Medicine | 9275 Chamberlayne Road, Mechanivsville, VA 23069 | 2014-04-28 |
| 1558781971 | Hospital Based Medical Services of Virginia-i PC | Physician Assistant | 9275 Chamberlayne Road, Mechanicsville, VA 23069 | 2014-04-24 |
| 1104240308 | Virgina Em-i Medical Services PC | Physician Assistant | 9275 Chamberlayne Road, Mechanicsville, VA 23069 | 2014-02-07 |
| 1124644042 | Neil Partridge | Pharmacist | 11231 Garland Park Ln, Hanover, VA 23069-0016 | 2020-06-17 |
| 1851869374 | Marlene Joan Adams | Counselor | 7240 Courtland Farm Rd, Hanover, VA 23069-1564 | 2018-11-02 |
| 1063077352 | Nina Sullivan | Nurse Practitioner | 7240 Courtland Farm Rd, Hanover, VA 23069-1564 | 2019-05-02 |
| 1083760730 | William Kenneth Trimble | Nurse Anesthetist, Certified Registered | 7307 Extreme Way, Hanover, VA 23069-1631 | 2007-01-26 |
| 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 |
|---|---|---|---|---|
| 1922585348 | Pb Outpatient Services Pennsylvania, LLC | Psychiatric Residential Treatment Facility | 544 Iron Ridge Rd, Hanover, PA 17331-6838 | 2018-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992322598 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 4700 Monterey Dr, Annandale, VA 22003-5927 | 2020-06-30 |
| 1003372780 | Monroe Operations, LLC | Psychiatric Residential Treatment Facility | 1620 Davidson Rd, Mc Lean, VA 22101-4304 | 2019-02-18 |
| 1093271777 | Monroe Operations, LLC | Psychiatric Residential Treatment Facility | 1622 Davidson Rd, Mc Lean, VA 22101-4304 | 2019-02-18 |
| 1841770849 | Monroe Operations, LLC | Psychiatric Residential Treatment Facility | 1624 Davidson Rd, Mc Lean, VA 22101-4304 | 2018-08-19 |
| 1275025694 | Strategic Healthcare of Virginia, Incorporated | Psychiatric Residential Treatment Facility | 468 Dryden Loop, Dryden, VA 24243 | 2018-06-01 |
| 1497283527 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 10416 Burke Lake Rd, Fairfax Station, VA 22039-1808 | 2017-06-02 |
| 1932635976 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 5949 Oakdale Rd, Mc Lean, VA 22101-3331 | 2017-05-11 |
| 1750823399 | Safe Haven Transitional Youth Services | Psychiatric Residential Treatment Facility | 3021 Macallan Pkwy, Henrico, VA 23231-7269 | 2016-11-14 |
| 1619324753 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 7809 Schelhorn Rd, Alexandria, VA 22306-2825 | 2016-05-18 |
| 1356722722 | Discovery Practice Management, Inc | Psychiatric Residential Treatment Facility | 5343 Summit Dr, Fairfax, VA 22030-6523 | 2015-06-11 |
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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.