Independence of Portage County, Inc.

Primary specialty

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

Legal business name

INDEPENDENCE OF PORTAGE COUNTY, INC.

Practice address

837 Cleveland Rd
Ravenna, OH 44266-2023

Phone

(330) 296-2851

Fax

(330) 296-8631

NPI assigned

Sep 28, 2010

Last updated

Sep 28, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Anna Barrett

Title

Executive Director

Phone

(330) 296-2851

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Paths to Independence - Cleveland Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932418779. Details of each certification follow.

• CCN 36G650 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 36G650

Legal name

PATHS TO INDEPENDENCE - CLEVELAND

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Nov 23, 2010

Last certification

Feb 13, 2025

Beds

9

Ownership / control type

Private (non-profit)

Facility address

837 Cleveland Road
Ravenna, OH 44266

Tax ID family

Independence of Portage County Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

• Paths to Independence, Inc.

  dba Paths to Independence - Highland

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ravenna, OH
  • NPI 1265684328
  NPD tax ID
• Paths to Independence, Inc.

  dba Paths to Independence - Vine

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Kent, OH
  • NPI 1528210754
  NPD tax ID
• Paths to Independence, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ravenna, OH
  • NPI 1548412760
  NPD tax ID
• Paths to Independence, Inc.

  dba Paths to Independence - Meridian

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ravenna, OH
  • NPI 1710139795
  NPD tax ID
• Paths to Independence, Inc.

  dba Paths to Independence - Lincoln

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ravenna, OH
  • NPI 1801048889
  NPD tax ID
• Paths to Independence, Inc.

  dba Paths to Independence - Washington

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Ravenna, OH
  • NPI 1891947875
  NPD tax ID

Locations

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1932418779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 E MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663129",
            "telephone_number": "330-296-2851",
            "fax_number": "330-296-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 CLEVELAND RD",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662023",
            "telephone_number": "330-296-2851",
            "fax_number": "330-296-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE OF PORTAGE COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "BARRETT",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-296-2851",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "PENDING",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paths to Independence - Cleveland",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Paula K Hurt Heritage
• Angela Marie Huth
• Melanie Ianni
• Toni Rose Impiccini
• Independence of Portage County, Inc.
• Stephany Indorf, PA-C
• Marisa Irwin, RN
• Charla L Jackson
• Joan Ellen Jacob, R.N.
• Michelle Alyce Jahnke, MD

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Ravenna, OH
• Providers in Ravenna, 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 Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.