WILLOWBROOKE AT TANNER
NPI 1104066265
Psychiatric Unit in Villa Rica, GA
NPI Status: Active since March 03, 2009
Contact Information
601 DALLAS HWY
VILLA RICA, GA
ZIP 30180
Phone: (770) 456-3000
Fax: (770) 456-3390
- Organization
- Psychiatric Unit
- CLIA Number: 11D1061560
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 11-20-2026
About WILLOWBROOKE AT TANNER
This page provides the complete NPI Profile along with additional information for Willowbrooke At Tanner, a provider established in Villa Rica, Georgia operating as a Psychiatric Unit. The healthcare provider is registered in the NPI registry with number 1104066265 assigned on March 2009. The practitioner's primary taxonomy code is 273R00000X. The provider is registered as an organization and their NPI record was last updated 16 years ago. The provider's is doing business as Willowbrooke At Tanner. The authorized official of this NPI record is Mr. Lee C. Sherseth (Cfo)
- NPI
- 1104066265
- Provider Legal Name
- TMC/VILLA RICA HOSPITAL, INC
- Other Organization Name
- WILLOWBROOKE AT TANNER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 601 DALLAS HWY VILLA RICA, GA 30180
- Location Phone
- (770) 456-3000
- Location Fax
- (770) 456-3390
- Mailing Address
- PO BOX 638 VILLA RICA, GA 30180
- Mailing Phone
- (770) 836-9666
- Mailing Fax
- (770) 456-3390
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-03-2009
- Last Update Date
- 07-28-2010
- 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
Psychiatric Unit
- Taxonomy Code
- 273R00000X
- Type
- Hospital Units
- Taxonomy Description
- In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000002032A | MEDICAID (05) | GA | |
| 11S015 | MEDICARE OSCAR/CERTIFICATION (06) | GA |
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
- 11D1061560
- Facility Type
- Hospital
- Certificate Effective Date
- November 21, 2024
- Certificate Expiration Date
- November 20, 2026
- Laboratory Director
- AARON E. HARPER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Willowbrooke At Tanner 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 NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104066265, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 45 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 12 providers are registered at the same or a nearby location.
VILLA RICA, GA 30180
VILLA RICA, GA 30180
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104066265, enumerated as an "organization" on March 03, 2009.
The provider is located at 601 DALLAS HWY VILLA RICA, GA 30180 and the phone number is (770) 456-3000.
Psychiatric Unit with taxonomy code 273R00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
