Provider Type Icon

OAK GROVE MANOR MRDD NPI 1285762450

NPI Profile

NPI: 1285762450
Provider Name: OAK GROVE MANOR MRDD
Classification: Intermediate Care Facility, Mentally Retarded - 315P00000X
Entity Type: Organization

CLIA Number: 36D0873999

Address:
1670 CRIDER RD
MANSFIELD, OH
ZIP 44903
Get Directions

Phone: (614) 459-2482

OAK GROVE MANOR MRDD is an intermediate care facility mentally retarded in Mansfield, OH. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. OAK GROVE MANOR MRDD NPI is 1285762450. The provider is registered as an organization entity type.

The provider's business location address is:

1670 CRIDER RD
MANSFIELD, OH
ZIP 44903-268
Phone: (614) 459-2482
Fax: (614) 459-2641

The provider's authorized official is Oscar G Aleman .
The authorized official title is Controller and has the following contact phone number (614) 459-2482.

The CLIA number assigned to this NPI record is 36D0873999 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1315P00000XIntermediate Care Facility, Mentally Retarded1783NOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
136-G150MEDICARE ID-TYPE UNSPECIFIEDOHIOMEDICARE PROVIDER #
22561464MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 8/10/2020

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.