Thi of Ohio at Boardman, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THI OF OHIO AT BOARDMAN, LLC

Doing business as

Boardman Specialty Care and Rehabilitation Center

Practice address

5665 South Ave
Youngstown, OH 44512-2459

Phone

(330) 782-1173

Fax

(330) 782-7642

NPI assigned

Oct 7, 2006

Last updated

Nov 21, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cynthia Woodburn

Title

President

Phone

(330) 782-1173

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Boardman Specialty Care and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1427145606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 SOUTH AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445122459",
            "telephone_number": "330-782-1173",
            "fax_number": "330-782-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF OHIO AT BOARDMAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "WOODBURN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-782-1173"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2410500",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boardman Specialty Care and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Skilled Nursing Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.