NPIMap

Organization Active NPI

Mellon Ridge, Inc.

Doing business as Peebles Resident Home

  • Assisted Living Facility
  • Peebles, OH
National Provider Identifier
1851504385
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
1955 Issued in OH
Legal business name
MELLON RIDGE, INC.
Doing business as
Peebles Resident Home
Practice address
25773 State Route 41
Peebles, OH 45660-8953
Phone
(937) 587-5414
Fax
(440) 614-0168
NPI assigned
May 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brian Colleran
Title
President
Phone
(440) 614-0160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 1955 OH Primary

Addresses

Primary practice location

25773 State Route 41
Peebles, OH 45660-8953

Mailing address

22021 Brookpark Rd
Ste 123
Fairview Park, OH 44126-3100
Phone (440) 614-0160

Other names 1

  • Peebles Resident Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mellon Ridge Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

22021 Brookpark Rd
Ste 123
Fairview Park, OH 44126
Phone (440) 614-0160

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851504385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22021 BROOKPARK RD",
            "address_2": "STE 123",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441263100",
            "telephone_number": "440-614-0160",
            "fax_number": "440-614-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25773 STATE ROUTE 41",
            "city": "PEEBLES",
            "state": "OH",
            "postal_code": "456608953",
            "telephone_number": "937-587-5414",
            "fax_number": "440-614-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELLON RIDGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLLERAN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-614-0160"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OH",
            "license": "1955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peebles Resident Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peebles, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.