Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Clementine Twin Lakes, LLC

Q: What type of organization is Clementine Twin Lakes, LLC?

Clementine Twin Lakes, LLC is registered in NPPES as a Psychiatric Residential Treatment Facility (its primary provider taxonomy).

Psychiatric Residential Treatment Facility in Fairfax Station, VA · enumerated 2021 · authorized official Mike Bagley, Chief Financial Officer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1689269250

Verified

See something wrong? Report a correction

Registry record

Entity type Organization (Type 2)

Legal business name Clementine Twin Lakes, LLC

Other name <Unavail>

Practice address 11329 Henderson Rd, Fairfax Station, VA, 22039

Phone (305) 663-1876

Enumeration date Mar 5, 2021

Last updated in NPPES Oct 16, 2025

Taxonomy & classification

261QM0855X Adolescent and Children Mental Health Clinic/Center Ambulatory Health Care Facilities Secondary

320800000X Mental Illness Community Based Residential Treatment Facility Residential Treatment Facilities Secondary

323P00000X Psychiatric Residential Treatment Facility Residential Treatment Facilities Primary

Authorized official

Name Mike Bagley

Title Chief Financial Officer

Phone (305) 663-1876

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

What type of organization is Clementine Twin Lakes, LLC?

Clementine Twin Lakes, LLC is registered in NPPES as a Psychiatric Residential Treatment Facility (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-10-16.