NPIMap

Organization Active NPI

Anne Grady Corporation

  • Intellectual Disabilities Intermediate Care Facility
  • Toledo, OH
National Provider Identifier
1114172905
Registry record updated Apr 15, 2022
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Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
ANNE GRADY CORPORATION
Practice address
5923 Everwood Rd
Toledo, OH 43613-1231
Phone
(419) 866-6500
Fax
(419) 866-7457
NPI assigned
Nov 21, 2008
Last updated
Apr 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Authorized official

Name
Steven King
Title
Executive Director
Phone
(419) 866-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

5923 Everwood Rd
Toledo, OH 43613-1231

Mailing address

1525 Eber Rd
Holland, OH 43528-9616
Phone (419) 866-6500

Other identifiers 1

IdentifierTypeStateIssuer
0919804MedicaidOH

Other names 1

  • Everwood Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114172905. Details of each certification follow.

  • CCN 36G469 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G469

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EVERWOOD COMMUNITY RESIDENCE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 2, 1993
Last certification
Jun 5, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
5923 Everwood Road
Toledo, OH 43613

National Provider Directory

National Provider Directory
Tax ID family
Anne Grady Corporation9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1114172905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 EBER RD",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289616",
            "telephone_number": "419-866-6500",
            "fax_number": "419-866-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5923 EVERWOOD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436131231",
            "telephone_number": "419-866-6500",
            "fax_number": "419-866-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNE GRADY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "419-866-6500"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0919804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everwood",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Everwood",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.