BRADFORD RIVER BEND, LLC
NPI 1194569855
Clinic/Center - Rehabilitation, Substance Use Disorder in Gautier, MS
NPI Status: Active since June 19, 2024
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- Accepts Insurance
- CLIA Number: 25D2307871
- CLIA Cert. Type: Other - PARTIAL HOSPITALIZATION
- CLIA Exp. Date: 07-15-2026
About BRADFORD RIVER BEND, LLC
This page provides the complete NPI Profile along with additional information for Bradford River Bend, Llc, a provider established in Gautier, Mississippi operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1194569855 assigned on June 2024. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mark Edwards (Cfo)
- NPI
- 1194569855
- Provider Name
- BRADFORD RIVER BEND, LLC
- Entity Type
- Organization
- Location Address
- 330 HIGHWAY 90 GAUTIER, MS 39553
- Location Phone
- (601) 791-5135
- Mailing Address
- 226 LOWE LN LUCEDALE, MS 39452
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-19-2024
- Last Update Date
- 06-19-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 25D2307871
- Facility Type
- Other - PARTIAL HOSPITALIZATION
- Certificate Effective Date
- July 16, 2024
- Certificate Expiration Date
- July 15, 2026
- Laboratory Director
- DONALD FAUCETT
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Bradford River Bend, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 9 | 4 | 5 | 6 | 9 | 8 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 18 | 4 | 10 | 6 | 18 | 8 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 8 + 4 + 1 + 0 + 6 + 1 + 8 + 8 + 1 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1194569855 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1194569855, enumerated in the NPI registry as an "organization" on June 19, 2024
The provider is located at 330 Highway 90 Gautier, Ms 39553 and the phone number is (601) 791-5135
This medical organization specializes in Clinic/Center with taxonomy code 261QR0405X with a focus in Rehabilitation, Substance Use Disorder
The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 25D2307871 for a "other - partial hospitalization" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on June 19, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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