Group One 20 LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

GROUP ONE 20 LLC

Practice address

22711 Nicholas Ave
Euclid, OH 44123-3257

Phone

(216) 571-8564

NPI assigned

Nov 29, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Theresa King

Title

Owner

Phone

(216) 571-8564

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

{
    "created_epoch": "1606608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606608000000",
    "number": "1750985974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22711 NICHOLAS AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441233257",
            "telephone_number": "216-571-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22711 NICHOLAS AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441233257",
            "telephone_number": "216-571-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP ONE 20 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-29",
        "last_updated": "2020-11-29",
        "certification_date": "2020-11-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-571-8564",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0408563",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "group120care@gmail.com",
            "affiliation": "N",
            "endpointDescription": "group120care@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22711 Nicholas Ave",
            "city": "Euclid",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441233257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "group120care@gmail.com",
            "affiliation": "N",
            "endpointDescription": "group120care@gmail.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22711 Nicholas Ave",
            "city": "Euclid",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441233257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Euclid, OH
• Providers in Euclid, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2020; 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.