Eastwood Residential Living, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

EASTWOOD RESIDENTIAL LIVING, INC.

Practice address

6455 N Ridge Rd Unit 1
Madison, OH 44057-2516

Phone

(440) 344-1158

NPI assigned

Oct 16, 2023

Organization subpart

No

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

Authorized official

Name

Heather Victor, MBA

Title

President

Phone

(440) 344-1158

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1750163713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6455 N RIDGE RD UNIT 1",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572516",
            "telephone_number": "440-344-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6455 N RIDGE RD UNIT 1",
            "city": "MADISON",
            "state": "OH",
            "postal_code": "440572516",
            "telephone_number": "440-344-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTWOOD RESIDENTIAL LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "VICTOR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-344-1158",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Madison, OH
• Providers in Madison, OH by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.