NPIMap

Organization Active NPI

Baymark Health Services of Ohio, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Willoughby, OH
National Provider Identifier
1053983189
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BAYMARK HEALTH SERVICES OF OHIO, INC.
Practice address
35110 Euclid Ave Ste 2
Willoughby, OH 44094-4523
Phone
(440) 336-8465
Fax
(440) 220-4611
NPI assigned
Jul 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

35110 Euclid Ave Ste 2
Willoughby, OH 44094-4523

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other names 1

  • Coleman Institute for Addiction Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baymark Health Services of Ohio Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

35110 Euclid Ave
Ste 2
Willoughby, OH 44094
Phone (440) 336-8465

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1053983189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300",
            "fax_number": "214-853-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35110 EUCLID AVE STE 2",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944523",
            "telephone_number": "440-336-8465",
            "fax_number": "440-220-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYMARK HEALTH SERVICES OF OHIO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coleman Institute for Addiction Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coleman Institute for Addiction Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willoughby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.