Active NPI
Elizabeth Ann Douce, INDEPENDENT PROVIDER
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Canton, OH
National Provider Identifier
1356935829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Practice address
- 6648 Marelis Ave NE
Canton, OH 44721-2469 - Phone
- (330) 418-3392
- Fax
- (330) 494-3337
- NPI assigned
- Feb 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
6648 Marelis Ave NE
Canton, OH 44721-2469
Mailing address
6648 Marelis Ave NE
Canton, OH 44721-2469
Phone (330) 418-3392
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103315602599 | Medicaid | OH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Canton | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1356935829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6648 MARELIS AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "447212469",
"telephone_number": "330-418-3392",
"fax_number": "330-494-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6648 MARELIS AVE NE",
"city": "CANTON",
"state": "OH",
"postal_code": "447212469",
"telephone_number": "330-418-3392",
"fax_number": "330-494-3337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUCE",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"credential": "INDEPENDENT PROVIDER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-25",
"last_updated": "2021-02-25",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103315602599",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Canton",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Canton",
"address_1": "6648 Marelis Ave NE",
"city": "Canton",
"state": "OH",
"country_code": "US",
"postal_code": "447212469",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.