NPIMap

Organization Active NPI

Central Ohio Group Homes, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Centerburg, OH
National Provider Identifier
1639172463
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
4210642 Issued in OH
Legal business name
CENTRAL OHIO GROUP HOMES, INC.
Doing business as
Canterbury Villa
Practice address
80 Miller St
Centerburg, OH 43011-9741
Phone
(740) 625-6873
NPI assigned
May 24, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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 and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 4210642 OH Primary

Addresses

Primary practice location

80 Miller St
Centerburg, OH 43011-9741

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2417530MedicaidOH

Other names 1

  • Canterbury Villa Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Ohio Group Homes 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": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1639172463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25000 COUNTRY CLUB BLVD",
            "address_2": "SUITE 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": "80 MILLER ST",
            "city": "CENTERBURG",
            "state": "OH",
            "postal_code": "430119741",
            "telephone_number": "740-625-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OHIO GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2014-06-16",
        "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": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "4210642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2417530",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canterbury Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centerburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.