Fidelity Residential and Community Suppor, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

FIDELITY RESIDENTIAL AND COMMUNITY SUPPOR, LLC

Practice address

5426 Woodgate Dr
Dayton, OH 45424-2744

Phone

(937) 641-1323

NPI assigned

Dec 24, 2021

Organization subpart

No

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

Authorized official

Name

Paul Ndayishimiye

Title

Chief Finacial Officer

Phone

(937) 641-1323

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1640304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640304000000",
    "number": "1871253310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5426 WOODGATE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454242744",
            "telephone_number": "937-641-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5426 WOODGATE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454242744",
            "telephone_number": "937-641-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDELITY RESIDENTIAL AND COMMUNITY SUPPOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-24",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A",
        "authorized_official_last_name": "NDAYISHIMIYE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINACIAL OFFICER",
        "authorized_official_telephone_number": "937-641-1323"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fidelity Health Care
• Fidelity Health Care Inc (Premier Health Pharmacy - MVH)
• Fidelity Health Care Inc (Expressions of Hope)
• Fidelity Orthopedic Inc
• Fidelity Orthopedic Incorporated
• Charles Fiden Jr.
• Jeffrey T Fiehrer
• Angela J Fields, RN
• Brett A Fields, MD
• Cadira Fields

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Dayton, OH
• Providers in Dayton, OH by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2021; 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.