NPIMap

Organization Active NPI

B. Riley Sober House

  • Addiction (Substance Use Disorder) Counselor
  • Cleveland, OH
National Provider Identifier
1124592894
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
B. RILEY SOBER HOUSE
Practice address
3719 Denison Ave
Cleveland, OH 44109-2691
Phone
(216) 417-4831
NPI assigned
Jan 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Authorized official

Name
Mr. Kenneth Alexander, M.ED., LPCC, LICDC
Title
Clinical Supervisor
Phone
(216) 444-1195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

3719 Denison Ave
Cleveland, OH 44109-2691

Mailing address

3719 Denison Ave
Cleveland, OH 44109-2691
Phone (216) 417-4831

Other identifiers 1

IdentifierTypeStateIssuer
1154835007MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
B Riley House3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/brileysoberhome/r4/

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1124592894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 DENISON AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441092691",
            "telephone_number": "216-417-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 DENISON AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441092691",
            "telephone_number": "216-417-4831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B. RILEY SOBER HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "216-444-1195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.ED., LPCC, LICDC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154835007",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; 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.