JEFFERSON TRAIL TREATMENT CENTER FOR CHILDREN (NPI# 1922395748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922395748 |
| Entity Type | Organization |
| Organization Name | JEFFERSON TRAIL TREATMENT CENTER FOR CHILDREN |
| Practice Address |
2101 Arlington Blvd Charlottesville VA 22903-1521 |
| Mailing Address |
110 Westwood Pl Suite 100 Brentwood TN 37027-5075 |
| Practice Telephone | 6152500283 |
| Practice Fax Number | 6152500000 |
| Mailing Telephone | 6152500283 |
| Mailing Fax Number | 6152500000 |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2011-06-30 |
| Authorized Official Name | VICKI TENCH (BUSINESS OFFICE DIRECTOR) |
| Authorized Official Telephone | 6152500283 |
| Authorized Official Credential | BOD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 63014001 | VA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 000207306 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740245117 | Jefferson Trail Treatment Center for Children | Psychiatric Hospital | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2006-04-19 |
| Street Address |
2101 ARLINGTON BLVD |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22903-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740245117 | Jefferson Trail Treatment Center for Children | Psychiatric Hospital | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2006-04-19 |
| 1740587062 | James Harris | Social Worker | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2011-02-23 |
| 1659602910 | Timothy Rambo | Counselor | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2010-01-26 |
| 1275786758 | Francesca Lomonaco | Social Worker | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2008-10-29 |
| 1487747572 | Julie Roebuck | Registered Nurse | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2006-10-02 |
| 1023060324 | Victoria Harper | Counselor | 2101 Arlington Blvd, Charlottesville, VA 22903-1521 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326671009 | Ticynn Symone London | Specialist/Technologist | 723 Retriever Run, Ticynn London, Charlottesville, VA 22903 | 2020-02-20 |
| 1043853542 | Elaine Mccall | Dietitian, Registered | 1335 Jefferson Park Ave, Charlottesville, VA 22903 | 2019-10-28 |
| 1205480753 | Sean Robert Bennett | Clinic/Center | 433 Ednam Drive, Charlottesville, VA 22903 | 2019-08-01 |
| 1922562818 | Lynn Owen Taggart | Student in an Organized Health Care Education/Training Program | 300 Grassmere Rd, Charlottesville, VA 22903 | 2019-01-25 |
| 1831636166 | Sarah Michelle Richin | Social Worker | 709 A West Main St, Charlottesville, VA 22903 | 2017-01-25 |
| 1962868851 | Kelly Stewart Maurer | Counselor | 3101 Fontaine Avenue, Charlottesville, VA 22903 | 2016-01-07 |
| 1831592039 | Bearley Dental PC | Dentist | 901 Preston Ave, Suite 200, Charlottesville, VA 22903 | 2014-10-01 |
| 1730437823 | Frances Eva Demmerle | Neuromusculoskeletal Medicine & OMM | 1149 Rose Hill Dr., Charlottesville, VA 22903 | 2012-08-21 |
| 1801142229 | University of Virginia | General Acute Care Hospital | 1925 Beechcrest Court, Charlottesville, VA 22903 | 2012-08-03 |
| 1407123516 | Laura P. Handler | Counselor | 500 Old Lynchburg Rd., Region Ten Csb, Charlottesville, VA 22903 | 2011-11-18 |
| Find all providers in zip 22903 | ||||
| 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 |
|---|---|---|---|---|
| 1841379658 | Vanessa A Camperlengo Md PC | Psychiatric Residential Treatment Facility | 675 Peter Jefferson Parkway, Suite 335, Charlottesville, VA 22911-8618 | 2006-11-03 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22903 |
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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.