Bleu House Residential

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

BLEU HOUSE RESIDENTIAL

Practice address

2426 Winfield Way NE
Canton, OH 44705-1952

Phone

(330) 356-9819

NPI assigned

Dec 19, 2022

Last updated

Dec 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Devon L Skillern, DO

Title

Owner

Phone

(330) 356-9819

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1144932526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 WINFIELD WAY NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447051952",
            "telephone_number": "330-356-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 WINFIELD WAY NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447051952",
            "telephone_number": "330-356-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLEU HOUSE RESIDENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-17",
        "status": "A",
        "authorized_official_last_name": "SKILLERN",
        "authorized_official_first_name": "DEVON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-356-9819",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Canton, OH
• Providers in Canton, OH by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.