Journey Community Church

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

JOURNEY COMMUNITY CHURCH

Practice address

21270 Lorain Rd
Fairview Park, OH 44126-2121

Phone

(330) 554-4009

NPI assigned

Nov 7, 2022

Organization subpart

No

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

Authorized official

Name

Mason Yoder

Title

Consultant

Phone

(330) 554-4009

Specialties & licenses 1

Addresses

Other names 1

• Joshua Tree Behavioral Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Tax ID family

Joshua Tree Behavioral Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Journey Community Church

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fairview Park, OH
  • NPI 1700594900
  NPD tax ID

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/joshuatreehealth/r4/

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Audra Maria Popik, MACC, LSW

  • Addiction (Substance Use Disorder) Counselor
  • North Olmsted, OH
  • NPI 1205265188

  Multi-Specialty

  Medicare reassignment NPD
• Sarah Tkac, LISW-S

  • Addiction (Substance Use Disorder) Counselor
  • Fairview Park, OH
  • NPI 1083159560
  NPD

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1619685815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21270 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21270 LORAIN RD",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262121",
            "telephone_number": "330-554-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY COMMUNITY CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "MASON",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "330-554-4009"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joshua Tree Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Joshua Tree Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathleen Ann Johnson
• Rachel Elizabeth Johnson, D.P.M.
• Kristine M. Jordan, LISW
• Joshua Tree Behavioral Health Center
• Joshua Tree Behavioral Health Center
• Journey Community Church
• Mangal Singh Kalsi
• Cheryl Ann Kalvitz, LPN
• Giuseppina Kalvitz
• Robin C Kananen

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fairview Park, OH
• Providers in Fairview Park, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.