Beth Shalom Ohio LLC

Primary specialty

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

Legal business name

BETH SHALOM OHIO LLC

Practice address

15802 Parkgrove Ave
Cleveland, OH 44110-1418

Phone

(267) 575-2225

NPI assigned

Aug 2, 2023

Last updated

Aug 2, 2023By 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

Gabriel Crowley

Title

Owner

Phone

(267) 575-2225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1225710825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15802 PARKGROVE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441101418",
            "telephone_number": "267-575-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15802 PARKGROVE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441101418",
            "telephone_number": "267-575-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH SHALOM OHIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "CROWLEY",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-575-2225"
    },
    "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 Cleveland, OH
• Providers in Cleveland, 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 Aug 2, 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.