NPIMap

Organization Active NPI

Portage County Children'S Services Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ravenna, OH
National Provider Identifier
1164062899
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PORTAGE COUNTY CHILDREN'S SERVICES CENTER
Practice address
771 N Freedom St
Ravenna, OH 44266
Phone
(330) 296-5552
Fax
(330) 296-6126
NPI assigned
Jan 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Tiffany Baldwin
Title
Billing Specialist
Phone
(330) 296-5552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

771 N Freedom St
Ravenna, OH 44266

Mailing address

771 N Freedom St
Ravenna, OH 44266
Phone (330) 296-5552

Other identifiers 1

IdentifierTypeStateIssuer
0390404MedicaidOH

Other names 1

  • Children's Advantage Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children'S Advantage4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1578614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1164062899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 N FREEDOM ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "44266",
            "telephone_number": "330-296-5552",
            "fax_number": "330-296-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 N FREEDOM ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "44266",
            "telephone_number": "330-296-5552",
            "fax_number": "330-296-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE COUNTY CHILDREN'S SERVICES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-10",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "330-296-5552"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0390404",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Advantage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Advantage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.