NPIMap

Organization Active NPI

Scioto Group Home, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Lucasville, OH
National Provider Identifier
1538436340
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
SCIOTO GROUP HOME, INC.
Doing business as
Scioto Trails Chalet
Practice address
374 Good Manor Rd
Lucasville, OH 45648-9606
Phone
(740) 289-2861
Fax
(740) 289-4355
NPI assigned
Nov 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Authorized official

Name
Brian Colleran
Title
President
Phone
(440) 614-0160

Specialties & licenses 1

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

Addresses

Primary practice location

374 Good Manor Rd
Lucasville, OH 45648-9606

Mailing address

25000 Country Club Blvd
Ste 255
North Olmsted, OH 44070-5344
Phone (440) 614-0160

Other identifiers 1

IdentifierTypeStateIssuer
6610153OtherOHDODD FACILITY NUMBER

Other names 1

  • Scioto Trails Chalet Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Scioto Group Home Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1538436340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD",
            "address_2": "STE 255",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705344",
            "telephone_number": "440-614-0160",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GOOD MANOR RD",
            "city": "LUCASVILLE",
            "state": "OH",
            "postal_code": "456489606",
            "telephone_number": "740-289-2861",
            "fax_number": "740-289-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCIOTO GROUP HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-22",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "COLLERAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-614-0160"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DODD FACILITY NUMBER",
            "identifier": "6610153",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scioto Trails Chalet",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lucasville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.