Northeast Regional Residential Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NORTHEAST REGIONAL RESIDENTIAL SERVICES LLC

Practice address

643 Easter Ave
Akron, OH 44307-1560

Phone

(254) 462-9978

NPI assigned

Apr 16, 2026

Organization subpart

No

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

Authorized official

Name

Mr. Travaughn Gordon

Title

Owner

Phone

(254) 462-9978

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1776297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1073457255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 EASTER AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 EASTER AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443071560",
            "telephone_number": "254-462-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST REGIONAL RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "TRAVAUGHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-462-9978",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.