Deepwood Industries, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

DEEPWOOD INDUSTRIES, INC

Practice address

8121 Deepwood Blvd
Mentor, OH 44060

Phone

(440) 350-5231

NPI assigned

Jan 26, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Gary Metelko

Title

Ceo

Phone

(440) 350-5231

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1508456294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8121 DEEPWOOD BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "440-350-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8121 DEEPWOOD BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "44060",
            "telephone_number": "440-350-5231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPWOOD INDUSTRIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "METELKO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-350-5231",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DODD-PROVIDER",
            "identifier": "4303480",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7914634",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanisha Deadwyler
• Jamie Deakins, OCPC
• Amber Lee Dean
• Estela Viviana Decastecker, D.D.S.
• Jessica Decore, QMHS
• Richard Joseph Defranco, MD
• Dakota Allan Dehn, LPCC, LICDC
• Kali Elizabeth Dehn, MS, LPCC, NCC
• Kate Deking
• Brittany Ryan Delasos, DO

• Developmentally Disabled Services Day Training Agency in Mentor, OH
• Providers in Mentor, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.