NPIMap

Organization Active NPI

Mellon Ridge, Inc.

  • Assisted Living Facility
  • Goshen, OH
National Provider Identifier
1609089135
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
2036 Issued in OH
Legal business name
MELLON RIDGE, INC.
Practice address
1659 State Route 28
Goshen, OH 45122-9705
Phone
(513) 575-5052
Fax
(440) 614-0168
NPI assigned
May 8, 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
Brian Colleran
Title
President
Phone
(440) 614-0160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 2036 OH Primary

Addresses

Primary practice location

1659 State Route 28
Goshen, OH 45122-9705

Mailing address

22021 Brookpark Rd
Ste 123
Fairview Park, OH 44126-3100
Phone (440) 614-0160

Other names 1

  • Mellon Ridge Residential Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mellon Ridge Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609089135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22021 BROOKPARK RD",
            "address_2": "STE 123",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263100",
            "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": "1659 STATE ROUTE 28",
            "city": "GOSHEN",
            "state": "OH",
            "postal_code": "451229705",
            "telephone_number": "513-575-5052",
            "fax_number": "440-614-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELLON RIDGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "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": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "2036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mellon Ridge Residential Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goshen, 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.