Baymark Health Services of Ohio, Inc.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Kent, OH
NPI 1740815380 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1740815380
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- BAYMARK HEALTH SERVICES OF OHIO, INC.
- Practice address
- 2500 State Route 59 Ste 28&30
Kent, OH 44240-7105 - Phone
- (330) 552-4000
- Fax
- (330) 552-4001
- NPI assigned
- Mar 4, 2020
- Organization subpart
- No
Authorized official
- Name
- Bruce Jarvie
- Title
- VP, Treasurer
- Phone
- (214) 379-3300
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 9
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2163184 | Baymark Health Services of Ohio, Inc | Certificate of waiver | Mar 7, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Opioid treatment program
- Medicare-enrolled since Oct 1, 2020
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201203002704 | OH | Part B Supplier - Opioid Treatment Program (Otp) | 3870845761 |
9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Columbus, OH; Youngstown, OH; Milford, OH; Lebanon, OH; Kent, OH; Dayton, OH; Amherst, OH |
National Provider Directory
- Tax ID family
- Baymark Health Services of Ohio Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
2500 State Route 59 Ste 28&30
Kent, OH 44240-7105
Mailing address
1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300
Other names
- MedMark Treatment Centers Kent
Other providers in Kent, OH
- Allison Kay Barnette
- Nicholas Glenn Barracato
- Anthony P Bartholomew
- Hannah Rose Bates
- Rachael Ann Bause
- Mar'Tazia Beach
- Beacon Support Services LLC
- Kelly Becker
- David Beckett
- Anne Beckwith
All providers in Kent, OH · Substance Use Disorder Rehabilitation Clinic/Center in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.