1518282177 NPI number — POST TREATMENT HOMES, INC.

Table of content: JAMES GARDNER COURTNEY III MD (NPI 1376346569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518282177 NPI number — POST TREATMENT HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POST TREATMENT HOMES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518282177
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 5127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESAPEAKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23324-0127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-354-9282
Provider Business Mailing Address Fax Number:
757-390-4524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4873 SOUTH OLIVER DRIVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23455-2700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-354-9282
Provider Business Practice Location Address Fax Number:
757-390-4524
Provider Enumeration Date:
04/07/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SAUL
Authorized Official First Name:
KRISTI
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
757-354-9282

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  CO-326-09 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: CO-326-09 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253J00000X , with the licence number: CO-326-09 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)