Provider Demographics
NPI:1083702229
Name:CHILDHELP, INC.
Entity Type:Organization
Organization Name:CHILDHELP, INC.
Other - Org Name:ALICE C. TYLER VILLAGE OF CHILDHELP
Other - Org Type:Other Name
Authorized Official - Title/Position:SR. DIRECTOR OF REVENUE CYCLE MGT.
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-617-0957
Mailing Address - Street 1:6730 N SCOTTSDALE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-4415
Mailing Address - Country:US
Mailing Address - Phone:276-617-0957
Mailing Address - Fax:480-922-7061
Practice Address - Street 1:23164 DRAGOON RD
Practice Address - Street 2:
Practice Address - City:LIGNUM
Practice Address - State:VA
Practice Address - Zip Code:22726-2036
Practice Address - Country:US
Practice Address - Phone:540-399-1926
Practice Address - Fax:540-399-9681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000207055Medicaid
WV0501039000Medicaid
MD2002736-00Medicaid