NPIMap

Organization Active NPI

Avenue to Independence LLC

  • Developmentally Disabled Services Day Training Agency
  • Canton, OH
National Provider Identifier
1033303987
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
7603856 Issued in OH
Legal business name
AVENUE TO INDEPENDENCE LLC
Practice address
1021 Roslyn Ave SW
Canton, OH 44710-1907
Phone
(330) 454-8719
NPI assigned
Sep 4, 2007
Last updated
Sep 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Authorized official

Name
Mr. David Martin Miday
Title
C.E.O.
Phone
(330) 933-2316

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 7603856 OH Primary
Non-emergency Medical Transport (VAN) 343900000X 7603856 OH

Addresses

Primary practice location

1021 Roslyn Ave SW
Canton, OH 44710-1907

Mailing address

1021 Roslyn Ave SW
Canton, OH 44710-1907
Phone (330) 454-8719

Other identifiers 1

IdentifierTypeStateIssuer
2724770MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1033303987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 ROSLYN AVE SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101907",
            "telephone_number": "330-454-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 ROSLYN AVE SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101907",
            "telephone_number": "330-454-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUE TO INDEPENDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "MIDAY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "330-933-2316",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "7603856",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "7603856",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2724770",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.