SOUTHSIDE BEHAVIORAL HEALTH - HOPE HOUSE
NPI 1730485905
Intermediate Care Facility, Intellectual Disabilities in La Crosse, VA

NPI Status: Active since February 04, 2011

Contact Information

154 CHARLOTTE AVE
LA CROSSE, VA
ZIP 23950
Phone: (434) 447-4008
Fax: (434) 447-4289

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  • Organization
  • Intermediate Care Facility, Intellectual...
  • CLIA Number: 49D2218179
  • CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
  • CLIA Exp. Date: 03-25-2027

About SOUTHSIDE BEHAVIORAL HEALTH - HOPE HOUSE

This page provides the complete NPI Profile along with additional information for Southside Behavioral Health - Hope House, a provider established in La Crosse, Virginia operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1730485905 assigned on February 2011. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Elizabeth C Engelhorn (Executive Director)

NPI
1730485905
Provider Name
SOUTHSIDE BEHAVIORAL HEALTH - HOPE HOUSE
Entity Type
Organization
Location Address
154 CHARLOTTE AVE LA CROSSE, VA 23950
Location Phone
(434) 447-4008
Location Fax
(434) 447-4289
Mailing Address
PO BOX 1478 143 INDUSTRIAL PARKWAY CLARKSVILLE, VA 23927
Mailing Phone
(434) 572-6916
Mailing Fax
(434) 447-4289
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-04-2011
Last Update Date
03-02-2021
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Location Map

Secondary Locations

  • 143 Industrial Pkwy
    Clarksville, VA 23927
    (434) 572-6916

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

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ELIZABETH C ENGELHORN

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(434) 572-6916

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
49D2218179
Facility Type
Intermediate Care Facility for Mentally Retarded
Certificate Effective Date
March 26, 2025
Certificate Expiration Date
March 25, 2027
Laboratory Director
PAUL MANDEL
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Southside Behavioral Health - Hope House 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.
1730485905
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2760881090
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 6 + 0 + 8 + 8 + 1 + 0 + 9 + 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 = 55

The NPI number 1730485905 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 1730485905, enumerated in the NPI registry as an "organization" on February 04, 2011

The provider is located at 154 Charlotte Ave La Crosse, Va 23950 and the phone number is (434) 447-4008

This medical organization specializes in Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X

The provider's CLIA number is 49D2218179 for a "intermediate care facility for mentally retarded" 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 February 04, 2011. 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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