Yggdrasil Residential Services

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

YGGDRASIL RESIDENTIAL SERVICES

Practice address

72480 Pattons Run Rd
Martins Ferry, OH 43935-9793

Phone

(740) 257-3815

NPI assigned

May 9, 2024

Organization subpart

No

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

Authorized official

Name

Marc Whitehouse

Title

Coo

Phone

(740) 257-3815

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1811745490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72480 PATTONS RUN RD",
            "city": "MARTINS FERRY",
            "state": "OH",
            "postal_code": "439359793",
            "telephone_number": "740-257-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72480 PATTONS RUN RD",
            "city": "MARTINS FERRY",
            "state": "OH",
            "postal_code": "439359793",
            "telephone_number": "740-257-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YGGDRASIL RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "WHITEHOUSE",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "740-257-3815"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Marie Whitecotton, LICDC
• Mia Williams
• Matthew M Wine, PHARM.D.
• Kim Wines
• Katherine Winters-Hazen, BCBA
• Loretta Yuhase, MA, PSYCH ASSISTANT
• Patrick P Zadrozny, DPT
• Nancy A Zinn Reed, LPCC

• Intellectual Disabilities Intermediate Care Facility in Martins Ferry, OH
• Providers in Martins Ferry, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.