Independent Provider

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

SP841892 Issued in OH

Legal business name

INDEPENDENT PROVIDER

Practice address

288 E 248TH St
Euclid, OH 44123-1437

Phone

(216) 303-4144

NPI assigned

Mar 8, 2017

Last updated

Mar 8, 2017By 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

L'Oreal Trigg

Title

LPN

Phone

(216) 303-4144

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1033650163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 E 248TH ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441231437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 E 248TH ST",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441231437",
            "telephone_number": "216-303-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PROVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "TRIGG",
        "authorized_official_first_name": "L'OREAL",
        "authorized_official_title_or_position": "LPN",
        "authorized_official_telephone_number": "216-303-4144"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "SP841892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Euclid, OH
• Providers in Euclid, OH by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.