NPIMap

Organization Active NPI

Richland County

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Mansfield, OH
National Provider Identifier
1891932398
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
7010406 Issued in OH
Legal business name
RICHLAND COUNTY
Practice address
592 Evelyn Ave
Mansfield, OH 44907
Phone
(419) 522-0611
NPI assigned
Jan 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Authorized official

Name
Ms. Elizabeth G Prather
Title
Superintendent
Phone
(419) 774-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 7010406 OH Primary

Addresses

Primary practice location

592 Evelyn Ave
Mansfield, OH 44907

Mailing address

314 Cleveland Ave
Mansfield, OH 44902-8623
Phone (419) 774-4200

Other identifiers 2

IdentifierTypeStateIssuer
2902630MedicaidOH
7010406OtherODMRDD

Other names 1

  • Evelyn Other name

National Provider Directory

National Provider Directory
Tax ID family
Richland Co Community Alternative Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

592 Evelyn Ave
Mansfield, OH 44907
Phone (419) 522-0611

NPI Registry JSON

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1891932398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 CLEVELAND AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449028623",
            "telephone_number": "419-774-4200",
            "fax_number": "419-774-4207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 EVELYN AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44907",
            "telephone_number": "419-522-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHLAND COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "PRATHER",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "419-774-4200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "OH",
            "license": "7010406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2902630",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODMRDD",
            "identifier": "7010406",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evelyn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.