NPIMap

Organization Active NPI

New Destiny Treatment Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Clinton, OH
National Provider Identifier
1821411273
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
NEW DESTINY TREATMENT CENTER, INC.
Practice address
6694 Taylor Rd
Clinton, OH 44216-9201
Phone
(330) 825-5202
Fax
(330) 825-5113
NPI assigned
Jan 21, 2014
Last updated
Dec 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Dr. Robert W. Bolois, PH.D., LICDC-CSNPI 1447785068
Title
Ceo
Phone
(330) 825-5202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X 34.005720 OH

Addresses

Primary practice location

6694 Taylor Rd
Clinton, OH 44216-9201

Mailing address

6694 Taylor Rd
Clinton, OH 44216-9201
Phone (330) 825-5202

Other identifiers 1

IdentifierTypeStateIssuer
0249609MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1821411273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6694 TAYLOR RD",
            "city": "CLINTON",
            "state": "OH",
            "postal_code": "442169201",
            "telephone_number": "330-825-5202",
            "fax_number": "330-825-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6694 TAYLOR RD",
            "city": "CLINTON",
            "state": "OH",
            "postal_code": "442169201",
            "telephone_number": "330-825-5202",
            "fax_number": "330-825-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW DESTINY TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-21",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "BOLOIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-825-5202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LICDC-CS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OH",
            "license": "34.005720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0249609",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.