Organization Active NPI

Independant Home Health Care Non-Aide

  • Physical Disabilities Residential Treatment Facility
  • Cuyahoga Falls, OH
National Provider Identifier
1417904103
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
2225612 Issued in OH
Legal business name
INDEPENDANT HOME HEALTH CARE NON-AIDE
Practice address
3406 Prange Dr
Cuyahoga Falls, OH 44223-3224
Phone
(330) 945-6304
NPI assigned
May 28, 2006
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
Ms. Yvonne Marie Cleavenger
Title
Home Health Care Provider
Phone
(330) 922-3330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 2225612 OH Primary

Addresses

Primary practice location

3406 Prange Dr
Cuyahoga Falls, OH 44223-3224

Mailing address

645 W Bath Rd
Cuyahoga Falls, OH 44223-3002
Phone (330) 922-3330

Other identifiers 2

IdentifierTypeStateIssuer
109005954201MedicaidOH
103293964599MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417904103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 W BATH RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233002",
            "telephone_number": "330-922-3330",
            "fax_number": "330-922-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 PRANGE DR",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233224",
            "telephone_number": "330-945-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDANT HOME HEALTH CARE NON-AIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEAVENGER",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "HOME HEALTH CARE PROVIDER",
        "authorized_official_telephone_number": "330-922-3330",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "OH",
            "license": "2225612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109005954201",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103293964599",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, 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.