NPIMap

Organization Active NPI

Maryhaven Inc.

  • Substance Abuse Rehabilitation Facility
  • Columbus, OH
National Provider Identifier
1922368166
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1183 Issued in OH
Legal business name
MARYHAVEN INC.
Practice address
1791 Alum Creek Dr
Columbus, OH 43207-1708
Phone
(614) 324-5402
Fax
(614) 827-8380
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Authorized official

Name
Mr. Gregory Michael Ritter, LPCC, LICDC-CS
Title
Billing/Medical Records Administrat
Phone
(614) 324-5402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1183 OH Primary

Addresses

Primary practice location

1791 Alum Creek Dr
Columbus, OH 43207-1708

Mailing address

1791 Alum Creek Dr
Columbus, OH 43207-1708
Phone (614) 324-5402

Other identifiers 1

IdentifierTypeStateIssuer
2864566MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Maryhaven3 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 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1922368166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 ALUM CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432071708",
            "telephone_number": "614-324-5402",
            "fax_number": "614-827-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1791 ALUM CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432071708",
            "telephone_number": "614-324-5402",
            "fax_number": "614-827-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYHAVEN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "RITTER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "BILLING/MEDICAL RECORDS ADMINISTRAT",
        "authorized_official_telephone_number": "614-324-5402",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPCC, LICDC-CS"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OH",
            "license": "1183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864566",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2017; 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.