NPIMap

Organization Active NPI

Neighborhood Health Association of Toledo, Inc.

Doing business as Unison Behavioral Health Center

  • Federally Qualified Health Center (FQHC)
  • Toledo, OH
National Provider Identifier
1861054447
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.
Doing business as
Unison Behavioral Health Center
Practice address
1425 Starr Ave
Toledo, OH 43605-2456
Phone
(419) 720-7883
Fax
(419) 720-7895
NPI assigned
Jul 3, 2019
Last updated
Jul 3, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Authorized official

Name
Kelly Jo Stone Kline
Title
RCM
Phone
(419) 720-7883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

1425 Starr Ave
Toledo, OH 43605-2456

Mailing address

313 Jefferson Ave
Toledo, OH 43604-1004
Phone (419) 720-7883

Other names 1

  • Unison Behavioral Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140228001224 OH Part B Supplier - Clinic/Group Practice 5698686665 Receives reassigned benefits from 19 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toledo, OH; Holland, OH
O20190820000944 OH Part A Provider - Federally Qualified Health Center (FQHC) 5698686665 Practice locations: Toledo, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861054447. Details of each certification follow.

Federally qualified health center certification: CCN 721818

Legal name
NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC
Doing business as
UNISON BEHAVIORAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 19, 2019
Last certification
Aug 19, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 28, 2019 in OH
Enrollment address
1425 Starr Ave
Toledo, OH 43605-2456

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Health Association of Toledo Inc16 organizations share this tax ID, including this one
Part of
Neighborhood Health Association of Toledo Inc

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Talmadge Thomas Individual Corporate DirectorPresident Sep 27, 2019
Jodi Gross Individual Corporate DirectorBoard Member Apr 1, 2018
Jose Balderas Individual Corporate DirectorBoard Member Sep 27, 2019
Jerry Boose Individual Corporate DirectorBoard Member Jul 2, 2024
Shane Douglas Individual Corporate OfficerCoo Jan 3, 2023
W-2 Managing EmployeeAd; Jan 3, 2023
Ward Barnett Individual Corporate DirectorBoard Member Jul 2, 2024
Angela Jordan Individual Corporate DirectorSecretary Sep 27, 2019
Michael Alexander Individual Corporate DirectorBoard Member Jun 1, 2014
Christopher Kiehl Individual Corporate DirectorBoard Member Sep 27, 2019
Jennifer Discher Individual Corporate DirectorBoard Member Jan 7, 2010
Doni Miller Individual Corporate OfficerCeo Mar 1, 1993
W-2 Managing EmployeeAd; Mar 1, 1993

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nexus Health CareToledo, OH, CCN 361105 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) May 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1861054447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 JEFFERSON AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041004",
            "telephone_number": "419-720-7883",
            "fax_number": "419-720-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 STARR AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436052456",
            "telephone_number": "419-720-7883",
            "fax_number": "419-720-7895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEIGHBORHOOD HEALTH ASSOCIATION OF TOLEDO, INC.",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "STONE KLINE",
        "authorized_official_first_name": "KELLY JO",
        "authorized_official_title_or_position": "RCM",
        "authorized_official_telephone_number": "419-720-7883"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unison Behavioral Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.