NPIMap

Organization Active NPI

Clean Slate Sober Living

  • Non-emergency Medical Transport (VAN)
  • Trotwood, OH
National Provider Identifier
1902404353
Registry record updated Nov 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
CLEAN SLATE SOBER LIVING
Practice address
714 E Main St
Trotwood, OH 45426-2909
Phone
(844) 548-7627
NPI assigned
Oct 16, 2020
Last updated
Nov 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2020

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

Authorized official

Name
Leiland WoodsNPI 1982102059
Title
Coo
Phone
(404) 782-2988

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X NU Primary

Addresses

Primary practice location

714 E Main St
Trotwood, OH 45426-2909

Mailing address

714 E Main St
Trotwood, OH 45426-2909
Phone (844) 548-7627

National Provider Directory

National Provider Directory
Tax ID family
Clean Slate Sober Living3 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604793600000",
    "number": "1902404353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E MAIN ST",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262909",
            "telephone_number": "844-548-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 E MAIN ST",
            "city": "TROTWOOD",
            "state": "OH",
            "postal_code": "454262909",
            "telephone_number": "844-548-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAN SLATE SOBER LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-08",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "LEILAND",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "404-782-2988"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trotwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.