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Cornell Abraxas Group, LLC

Organization Active NPI Children's Substance Abuse Rehabilitation Facility · Shelby, OH

NPI 1376518902 · NPPES record last updated Jun 13, 2022

Key facts

NPI
1376518902
Entity type
Organization (NPI type 2)
Primary specialty
Children's Substance Abuse Rehabilitation Facility 3245S0500X
License
FACSIS 256 (OH)
Legal business name
CORNELL ABRAXAS GROUP, LLC
Practice address
2775 State Route 39
Shelby, OH 44875-9466
Phone
(419) 747-3322
Fax
(381) 657-9702
NPI assigned
Feb 17, 2006
Organization subpart
No

Authorized official

Name
Julia Vogt
Title
Business Manager
Phone
(419) 747-0881

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 10

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

Practitioners 252

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

View all 252

National Provider Directory

Tax ID family
Cornell Abraxas Group LLC (11 organizations share this tax ID)

Locations

2775 State Route 39
Shelby, OH 44875
Phone (419) 747-3322

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0680 OH
Children's Substance Abuse Rehabilitation Facility 3245S0500X FACSIS 256 OH Yes

Addresses

Primary practice location

2775 State Route 39
Shelby, OH 44875-9466

Mailing address

2775 State Route 39
Shelby, OH 44875-9466
Phone (419) 747-3322

Other identifiers

IdentifierTypeStateIssuer
0063924MedicaidOH
2876928MedicaidOH

Other providers in Shelby, OH

All providers in Shelby, OH · Children's Substance Abuse Rehabilitation Facility in Ohio

Sources for this page

Verify at the official NPI Registry.