NPIMap

Organization Active NPI

Koinonia Partners Unlimited, LLC

  • Voluntary or Charitable Agency
  • Westlake, OH
National Provider Identifier
1235374307
Registry record updated Dec 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
KOINONIA PARTNERS UNLIMITED, LLC
Practice address
25666 Chaucer Dr
Westlake, OH 44145-4730
Phone
(440) 979-9182
NPI assigned
Dec 3, 2008
Organization subpart
Yes
Parent organization
KOINONIA PARTNERS UNLIMITED, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 3, 2008

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

Authorized official

Name
Diane Beastrom
Title
Ceo
Phone
(216) 588-8777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

25666 Chaucer Dr
Westlake, OH 44145-4730

Mailing address

6161 Oak Tree Blvd
Suite #400
Independence, OH 44131-2516
Phone (216) 588-8777

Other names 1

  • Chaucer Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G553

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CHAUCER HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Dec 3, 1999
Last certification
May 14, 2024
Beds
6
Ownership / control type
Private (non-profit)
Facility address
25666 Chaucer Avenue
Westlake, OH 44145

National Provider Directory

National Provider Directory
Tax ID family
Koinonia Partners Unlimited LLC11 organizations share this tax ID, including this one
Part of
Koinonia Partners Unlimited LLC

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1235374307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6161 OAK TREE BLVD",
            "address_2": "SUITE #400",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312516",
            "telephone_number": "216-588-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25666 CHAUCER DR",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454730",
            "telephone_number": "440-979-9182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOINONIA PARTNERS UNLIMITED, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KOINONIA PARTNERS UNLIMITED, LLC",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "BEASTROM",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-588-8777"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chaucer Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westlake, OH

Sources for this page

Verify at the official NPI Registry.