Active NPI
Taressa M. Kebbeh
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Canton, OH
National Provider Identifier
1871322321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Practice address
- 1110 Wertz Ave SW
Canton, OH 44710-2036 - Phone
- (330) 327-8011
- NPI assigned
- Jul 31, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | |||
| Adult Companion | 372600000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | |||
| Home Health Aide | 374U00000X | |||
| Private Vehicle | 347C00000X | |||
| Chore Provider | 372500000X | |||
| Homemaker | 376J00000X | |||
| Child Physical Disabilities Respite Care | 385HR2065X | |||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | Primary | ||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | |||
| Driver | 172A00000X | |||
| Community Health Worker | 172V00000X | |||
| Meals Provider | 174200000X |
Addresses
Primary practice location
1110 Wertz Ave SW
Canton, OH 44710-2036
Mailing address
1110 Wertz Ave SW
Canton, OH 44710-2036
Phone (330) 327-8011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722384000000",
"number": "1871322321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 WERTZ AVE SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447102036",
"telephone_number": "330-327-8011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 WERTZ AVE SW",
"city": "CANTON",
"state": "OH",
"postal_code": "447102036",
"telephone_number": "330-327-8011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEBBEH",
"first_name": "TARESSA",
"middle_name": "M.",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-31",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"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 Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.