NPIMap

Organization Active NPI

Cuyahoga County BD of MRDD

Doing business as Green House

  • Intellectual Disabilities Intermediate Care Facility
  • Cleveland, OH
National Provider Identifier
1407060684
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
1815533 Issued in OH
Legal business name
CUYAHOGA COUNTY BD OF MRDD
Doing business as
Green House
Practice address
1905 Green Rd
Cleveland, OH 44112-1021
Phone
(216) 736-2526
Fax
(216) 736-2702
NPI assigned
May 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Terrence Ryan
Title
Superintendent
Phone
(216) 736-2625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 1815533 OH Primary

Addresses

Primary practice location

1905 Green Rd
Cleveland, OH 44112-1021

Mailing address

1275 Lakeside Ave E
Cleveland, OH 44114-1132
Phone (216) 736-2625

Other names 1

  • Green House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cuyahoga County BD of MRD47 organizations share this tax ID, including this one

Other organizations with this tax ID 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407060684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 LAKESIDE AVE E",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441141132",
            "telephone_number": "216-736-2625",
            "fax_number": "216-736-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 GREEN RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121021",
            "telephone_number": "216-736-2526",
            "fax_number": "216-736-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUYAHOGA COUNTY BD OF MRDD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "216-736-2625",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "1815533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green House",
            "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 Aug 22, 2020; 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.