NPIMap

Organization Active NPI

Gentlebrook

  • Intellectual Disabilities Intermediate Care Facility
  • West Lafayette, OH
National Provider Identifier
1356926224
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
GENTLEBROOK
Practice address
22077 TR 1064
West Lafayette, OH 43845
Phone
(740) 545-6366
Fax
(740) 545-6090
NPI assigned
Mar 12, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Tana Fischer
Title
Home Health Administrator
Phone
(740) 622-7406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

22077 TR 1064
West Lafayette, OH 43845

Mailing address

880 Sunnyside St SW
Hartville, OH 44632-9087
Phone (330) 877-7700

Other practice location 1

22079 TR 1064
West Lafayette, OH 43845-4384
Phone (740) 545-6366

Other practice location 2

640 Menlo Park St SW
Hartville, OH 44632-9698
Phone (330) 877-7700

National Provider Directory

National Provider Directory
Tax ID family
The Homestead of Coshocton18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1356926224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 SUNNYSIDE ST SW",
            "city": "HARTVILLE",
            "state": "OH",
            "postal_code": "446329087",
            "telephone_number": "330-877-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22077 TR 1064",
            "city": "WEST LAFAYETTE",
            "state": "OH",
            "postal_code": "43845",
            "telephone_number": "740-545-6366",
            "fax_number": "740-545-6090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22079 TR 1064",
            "address_purpose": "LOCATION",
            "city": "West Lafayette",
            "state": "OH",
            "postal_code": "438454384",
            "country_code": "US",
            "telephone_number": "740-545-6366",
            "fax_number": "740-545-6090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "640 Menlo Park St SW",
            "address_purpose": "LOCATION",
            "city": "Hartville",
            "state": "OH",
            "postal_code": "446329698",
            "country_code": "US",
            "telephone_number": "330-877-7700",
            "fax_number": "330-877-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENTLEBROOK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "TANA",
        "authorized_official_title_or_position": "HOME HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "740-622-7406"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.