NPIMap

Organization Active NPI

Firelands Regional Medical Center

Doing business as Firelands Counseling & Recovery Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lorain, OH
National Provider Identifier
1386878304
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FIRELANDS REGIONAL MEDICAL CENTER
Doing business as
Firelands Counseling & Recovery Services
Practice address
6150 Park Square Dr Ste B
Lorain, OH 44053-4153
Phone
(440) 984-3882
Fax
(440) 984-3883
NPI assigned
May 5, 2009
Last updated
Sep 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Authorized official

Name
Mr. Daniel J Moncher
Title
Executive Vice President & Cfo
Phone
(419) 557-7793

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

6150 Park Square Dr Ste B
Lorain, OH 44053-4153

Mailing address

6150 Park Square Dr Ste B
Lorain, OH 44053-4153
Phone (440) 984-3882

Other identifiers 1

IdentifierTypeStateIssuer
3293725MedicaidOH

Other names 1

  • Firelands Counseling & Recovery Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000236 OH Part B Supplier - Clinic/Group Practice 6103734645 Receives reassigned benefits from 36 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandusky, OH

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

315 N Leavitt Rd
Amherst, OH 44001
Phone (440) 984-3882

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569283200000",
    "number": "1386878304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 PARK SQUARE DR STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534153",
            "telephone_number": "440-984-3882",
            "fax_number": "440-984-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 PARK SQUARE DR STE B",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440534153",
            "telephone_number": "440-984-3882",
            "fax_number": "440-984-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRELANDS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2019-09-24",
        "status": "A",
        "authorized_official_last_name": "MONCHER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "419-557-7793",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3293725",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firelands Counseling & Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Firelands Counseling & Recovery Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lorain, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.