NPIMap

Organization Active NPI

Premier Care of Ohio, LLC

Doing business as Community Medical Services Cleveland on Brookpark

  • Methadone Clinic
  • Cleveland, OH
National Provider Identifier
1386334340
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PREMIER CARE OF OHIO, LLC
Doing business as
Community Medical Services Cleveland on Brookpark
Practice address
6300 Brookpark Rd
Cleveland, OH 44129-1219
Phone
(440) 672-6955
Fax
(216) 331-1175
NPI assigned
May 11, 2023
Last updated
Feb 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Cindy Gaither
Title
VP Revenue Cycle MGMT
Phone
(602) 248-8886

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Methadone Clinic 261QM2800X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

6300 Brookpark Rd
Cleveland, OH 44129-1219

Mailing address

8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (480) 494-2497

Other names 1

  • COMMUNITY MEDICAL SERVICES CLEVELAND ON BROOKPARK Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2284660Community Medical Services6300 Brookpark Rd, Cleveland, OH 44129Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premier Care of Ohio LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1386334340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "480-494-2497",
            "fax_number": "480-687-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 BROOKPARK RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441291219",
            "telephone_number": "440-672-6955",
            "fax_number": "216-331-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARE OF OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "GAITHER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "VP REVENUE CYCLE MGMT",
        "authorized_official_telephone_number": "602-248-8886"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMMUNITY MEDICAL SERVICES CLEVELAND ON BROOKPARK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COMMUNITY MEDICAL SERVICES CLEVELAND ON BROOKPARK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.