Crisis Intervention and Recovery Center, Inc.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

0203 Issued in OH

Legal business name

CRISIS INTERVENTION AND RECOVERY CENTER, INC.

Practice address

832 McKinley Ave NW
Canton, OH 44703-2463

Phone

(330) 452-9812

Fax

(330) 430-1288

NPI assigned

Apr 30, 2012

Last updated

Apr 30, 2012By 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

Mr. Bernard Jesiolowski, PHD.

Title

Executive Director

Phone

(330) 452-9812

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Crisis Intervention and Recovery Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Crisis Intervention and Recovery Center, Inc.

  • Voluntary or Charitable Agency
  • Canton, OH
  • NPI 1902075955
  NPD tax ID

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1033477906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 MCKINLEY AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447032463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 MCKINLEY AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447032463",
            "telephone_number": "330-452-9812",
            "fax_number": "330-430-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISIS INTERVENTION AND RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "JESIOLOWSKI",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-452-9812",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "OH",
            "license": "0203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2863843",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2480864",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Crayden, MSW, LISW-S
• Nicole Crewes, PT, DPT
• Benjamin Lee Crews, DO
• Courtney Raschell Crews
• Crisis Intervention and Recovery Center
• Crisis Intervention and Recovery Center, Inc.
• Crisis Intervention and Recovery Center, Inc.
• Kylee N Crislip, LPCC-S
• Phillip Crislip
• Christina Cristino, PA-C

• Adult Mental Health Clinic/Center in Canton, OH
• Providers in Canton, OH by specialty
• Adult Mental Health Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.