The Bethel Group Home Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

2169 Issued in OH

Legal business name

THE BETHEL GROUP HOME INC.

Practice address

2107 4TH St
Cuyahoga Falls, OH 44221-3211

Phone

(330) 928-5757

NPI assigned

Aug 7, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deonna Lacrissa Samuel, M.S.

Title

President

Phone

(330) 928-5757

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1013349513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 4TH ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442213211",
            "telephone_number": "330-928-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 4TH ST",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442213211",
            "telephone_number": "330-928-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BETHEL GROUP HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "DEONNA",
        "authorized_official_middle_name": "LACRISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-928-5757",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "OH",
            "license": "2169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Adult Care Home Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.