NPIMap

Organization Active NPI

Keystone Richland Center, LLC

Doing business as Foundations for Living AOD

  • Children's Substance Abuse Rehabilitation Facility
  • Mansfield, OH
National Provider Identifier
1750648424
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
11-2079 Issued in OH
Legal business name
KEYSTONE RICHLAND CENTER, LLC
Doing business as
Foundations for Living AOD
Practice address
1451 Lucas Rd
Mansfield, OH 44903-8682
Phone
(419) 589-5511
Fax
(615) 250-1000
NPI assigned
Apr 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Connie Rebane
Title
Ceo
Phone
(419) 589-5511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 11-2079 OH Primary

Addresses

Primary practice location

1451 Lucas Rd
Mansfield, OH 44903-8682

Mailing address

1451 Lucas Rd
Mansfield, OH 44903-8682
Phone (419) 589-5511

Other names 1

  • Foundations for Living AOD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Keystone Richland Center LLC3 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": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1750648424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 LUCAS RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449038682",
            "telephone_number": "419-589-5511",
            "fax_number": "615-250-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 LUCAS RD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449038682",
            "telephone_number": "419-589-5511",
            "fax_number": "615-250-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE RICHLAND CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "REBANE",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-589-5511"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "OH",
            "license": "11-2079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foundations for Living AOD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.