NPIMap

Organization Active NPI

New Avenues to Independence, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Cleveland, OH
National Provider Identifier
1467573089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
9402 Issued in OH
Legal business name
NEW AVENUES TO INDEPENDENCE, INC.
Practice address
13802 Lake Shore Blvd
Cleveland, OH 44110-1905
Phone
(216) 481-1909
Fax
(216) 481-2050
NPI assigned
Apr 2, 2007
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
Randall Simmons, CPA
Title
Chief Financial Officer
Phone
(216) 481-1909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 9402 OH Primary

Addresses

Primary practice location

13802 Lake Shore Blvd
Cleveland, OH 44110-1905

Mailing address

17608 Euclid Ave
Cleveland, OH 44112-1216

Other identifiers 1

IdentifierTypeStateIssuer
0870044MedicaidOH

Other names 1

  • New Avenues-Bratenahl Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Avenues to Independence Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

17608 Euclid Ave
Cleveland, OH 44112
Phone (216) 417-6166

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467573089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17608 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441121216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13802 LAKE SHORE BLVD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441101905",
            "telephone_number": "216-481-1909",
            "fax_number": "216-481-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW AVENUES TO INDEPENDENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "216-481-1909",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "9402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0870044",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Avenues-Bratenahl",
            "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.