Portage Industries, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

3008051 Issued in OH

Legal business name

PORTAGE INDUSTRIES, INC.

Practice address

785 N Freedom St
Ravenna, OH 44266-2469

Phone

(330) 839-8671

NPI assigned

Sep 16, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Philip Miller

Title

Ceo

Phone

(330) 296-3996

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1932657152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7008 STATE ROUTE 88",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442669188",
            "telephone_number": "330-296-3996",
            "fax_number": "330-296-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 N FREEDOM ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442662469",
            "telephone_number": "330-839-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE INDUSTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "330-296-3996",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "OH",
            "license": "3008051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3008051",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.