VCPHCS XVII LLC NPI 1508202524

NPI Information

NPI: 1508202524
Provider Name: VCPHCS XVII, LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 44D2057546

Address:
1202 S JAMES CAMPBELL BLVD
SUITE 7A
COLUMBIA, TN
ZIP 38401
Phone: (931) 381-0020
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VCPHCS XVII, LLC is a rehabilitation and substance use disorder clinic center in Columbia, TN. VCPHCS XVII, LLC NPI is 1508202524. The provider is registered as an organization entity type.

The provider's business location address is:

1202 S JAMES CAMPBELL BLVD
SUITE 7A
COLUMBIA, TN
ZIP 38401-193
Phone: (931) 381-0020
Fax: (931) 381-0029

The provider's authorized official is Jemece Michelle Gasaway .
The authorized official title is Director Of Licensing and has the following contact phone number (214) 365-6126.

The CLIA number assigned to this NPI record is 44D2057546 - other - outpatient treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/16/2013 and was last updated on 2/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			No
2	261QM2800X	Clinic/Center	Methadone	L000000012587	TENNESSEE	No
3	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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