Elyria Large Group Homes, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

ELYRIA LARGE GROUP HOMES, INC.

Practice address

1251 East Ave
Elyria, OH 44035-7674

Phone

(440) 322-0726

Fax

(440) 322-2810

NPI assigned

Sep 10, 2007

Organization subpart

No

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

Authorized official

Name

Brian Colleran

Title

President

Phone

(440) 614-0160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Palm Crest Doing business as

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1154516581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD",
            "address_2": "STE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705344",
            "telephone_number": "440-614-0160",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 EAST AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440357674",
            "telephone_number": "440-322-0726",
            "fax_number": "440-322-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYRIA LARGE GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "COLLERAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-614-0160"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2940410",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Crest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elyria Medical Center LLC
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• Elyria Obstetrics & Gynecology Inc
• Elyria Township Trustee
• Emh Professional Services Inc.

• Intellectual Disabilities Intermediate Care Facility in Elyria, OH
• Providers in Elyria, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.