Mental Disability Health & Community Residential LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MENTAL DISABILITY HEALTH & COMMUNITY RESIDENTIAL LLC

Practice address

3790 Sherwood Rd
South Euclid, OH 44121-1940

Phone

(216) 773-0532

NPI assigned

Jun 3, 2020

Last updated

Jun 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Morgan Coleman

Title

Agency Administrator

Phone

(216) 773-0532

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1013531219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3790 SHERWOOD RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441211940",
            "telephone_number": "216-773-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 SHERWOOD RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441211940",
            "telephone_number": "216-773-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL DISABILITY HEALTH & COMMUNITY RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "AGENCY ADMINISTRATOR",
        "authorized_official_telephone_number": "216-773-0532"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy McKinney
• Lashon McKnight
• Talley O'Connor McMonagle, LISW-S
• Gail McNamara
• Aahnesty Melton
• Taylor Ann Meredith-Pickett
• Christopher M Merritt
• Shauntia Nicole Merritt, LPN
• Michael M Supler & Associates Inc (University Suburban Physical Therapy University Suburban Sports Medici)
• Tanya Joi Middleton, LPCC LCDC III

• Community/Behavioral Health Agency in South Euclid, OH
• Providers in South Euclid, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.