Active NPI
Medina Creative Accessibility
- In Home Supportive Care Agency
- Medina, OH
National Provider Identifier
1154938694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- MEDINA CREATIVE ACCESSIBILITY
- Practice address
- 224 N Court St
Medina, OH 44256-1980 - Phone
- (330) 591-4434
- NPI assigned
- Sep 29, 2020
- Organization subpart
- Yes
- Parent organization
- MEDINA CREATIVE HOUSING
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Dianne Depasquale-Hagerty
- Title
- Chief Executive Officer
- Phone
- (330) 591-4434
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary | ||
| Respite Care Camp | 385HR2050X |
Addresses
Primary practice location
224 N Court St
Medina, OH 44256-1980
Mailing address
224 N Court St
Medina, OH 44256-1980
Phone (330) 591-4434
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5211265 | Medicaid | OH |
Other names 1
- Medina Creative Housing
National Provider Directory
National Provider Directory- Part of
- Medina Creative Accessibility
Locations
224 N Court St
Medina, OH 44256
Phone (330) 591-4434
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601337600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601337600000",
"number": "1154938694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 N COURT ST",
"city": "MEDINA",
"state": "OH",
"postal_code": "442561980",
"telephone_number": "330-591-4434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 N COURT ST",
"city": "MEDINA",
"state": "OH",
"postal_code": "442561980",
"telephone_number": "330-591-4434"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDINA CREATIVE ACCESSIBILITY",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MEDINA CREATIVE HOUSING",
"enumeration_date": "2020-09-29",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A",
"authorized_official_last_name": "DEPASQUALE-HAGERTY",
"authorized_official_first_name": "DIANNE",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "330-591-4434",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "385HR2050X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care Camp",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5211265",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Medina Creative Housing",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Medina, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.