NPIMap

Organization Active NPI

Crisis Intervention and Recovery Center, Inc.

  • Voluntary or Charitable Agency
  • Canton, OH
National Provider Identifier
1831162817
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
License
0203 Issued in OH
Legal business name
CRISIS INTERVENTION AND RECOVERY CENTER, INC.
Practice address
832 McKinley Ave NW
Canton, OH 44703-2463
Phone
(330) 452-9812
NPI assigned
Feb 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Authorized official

Name
Dr. Bernard Jesiolowski, PHD.
Title
Executive Director
Phone
(330) 452-9812

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X 0203 OH Primary

Addresses

Primary practice location

832 McKinley Ave NW
Canton, OH 44703-2463

Mailing address

832 McKinley Ave NW
Canton, OH 44703-2463
Phone (330) 452-9812

Other identifiers 1

IdentifierTypeStateIssuer
0201098MedicaidOH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 99

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 99

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1831162817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 MCKINLEY AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447032463",
            "telephone_number": "330-452-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 MCKINLEY AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447032463",
            "telephone_number": "330-452-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISIS INTERVENTION AND RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "JESIOLOWSKI",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-452-9812",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "OH",
            "license": "0203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201098",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

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