NPIMap

Organization Active NPI

Paths to Independence, Inc.

Doing business as Paths to Independence - Vine

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kent, OH
National Provider Identifier
1528210754
Registry record updated Oct 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
24321 Issued in OH
Legal business name
PATHS TO INDEPENDENCE, INC.
Doing business as
Paths to Independence - Vine
Practice address
923 Vine St
Kent, OH 44240-3800
Phone
(330) 296-2851
Fax
(330) 296-8631
NPI assigned
Oct 21, 2008
Last updated
Oct 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2008

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

Authorized official

Name
Anna Barrett
Title
Executive Director
Phone
(330) 296-2851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 24321 OH Primary

Addresses

Primary practice location

923 Vine St
Kent, OH 44240-3800

Mailing address

161 E Main St
Ravenna, OH 44266-3129
Phone (330) 296-2851

Other identifiers 2

IdentifierTypeStateIssuer
24321OtherOHMR LICENSE NUMBER
2439301MedicaidOH

Other names 1

  • Paths to Independence - Vine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528210754. Details of each certification follow.

  • CCN 36G178 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G178

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PATHS TO INDEPENDENCE VINE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 30, 1984
Last certification
May 14, 2024
Beds
6
Ownership / control type
Private (non-profit)
Most recent change of ownership
Jan 1, 2004
Facility address
923 Vine Street
Kent, OH 44240

National Provider Directory

National Provider Directory
Tax ID family
Independence of Portage County Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

161 E Main St
Ravenna, OH 44266
Phone (330) 296-2851

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225411200000",
    "number": "1528210754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663129",
            "telephone_number": "330-296-2851",
            "fax_number": "330-296-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 VINE ST",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442403800",
            "telephone_number": "330-296-2851",
            "fax_number": "330-296-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHS TO INDEPENDENCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-31",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-296-2851"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "24321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MR LICENSE NUMBER",
            "identifier": "24321",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2439301",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paths to Independence - Vine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kent, OH

Sources for this page

Verify at the official NPI Registry.