Mary McLeod-Bethune Intervention & Enrichment Center

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

705115 Issued in OH

Legal business name

MARY MCLEOD-BETHUNE INTERVENTION & ENRICHMENT CENTER

Practice address

271 Hedges St
Mansfield, OH 44902-8611

Phone

(419) 545-4021

Fax

(419) 529-3488

NPI assigned

Aug 21, 2014

Last updated

Aug 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sheryl Lovely

Title

President

Phone

(419) 545-5041

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1780083162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5503",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449015503",
            "telephone_number": "419-545-4021",
            "fax_number": "419-529-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 HEDGES ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449028611",
            "telephone_number": "419-545-4021",
            "fax_number": "419-529-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MCLEOD-BETHUNE INTERVENTION & ENRICHMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "LOVELY",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-545-5041"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "OH",
            "license": "705115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2764469",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hope Erin Martin
• Jacqueline Martin, P.T., D.P.T.
• Justin Lee Martin, MPT
• Victoria Lynn Martin
• Bryan D Martz
• Philip Joseph Marzetti, PTA
• Laura Alexandria Masimore, APRN, CNM, WHNP
• Anabil Mason, LPN
• Jakob Mason
• Michael Mason

• Non-emergency Medical Transport (VAN) in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Non-emergency Medical Transport (VAN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.