Community Integration Supports

Primary specialty

HomemakerTaxonomy code 376J00000X

Legal business name

COMMUNITY INTEGRATION SUPPORTS

Practice address

635 Carson Salt Springs Rd
Mineral Ridge, OH 44440-9334

Phone

(330) 503-2224

NPI assigned

Sep 7, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Randall Allan Burns Jr.

Title

Ao

Phone

(330) 503-2224

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1053197798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 CARSON SALT SPRINGS RD",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409334",
            "telephone_number": "330-503-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 CARSON SALT SPRINGS RD",
            "city": "MINERAL RIDGE",
            "state": "OH",
            "postal_code": "444409334",
            "telephone_number": "330-503-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INTEGRATION SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "330-503-2224",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Homemaker in Mineral Ridge, OH
• Providers in Mineral Ridge, OH by specialty
• Homemaker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.