COUP DE MAIN NPI 1174451058

NPI Information

  • NPI: 1174451058
  • Provider Name: COUP DE MAIN
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Address: 1624 PLAIN AVE NE
    CANTON, OH
    ZIP 44714
  • Phone: (330) 224-7560

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NPI Details

COUP DE MAIN is a community based residential treatment facility, intellectual and/or developmental disabilities in Canton, OH. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. COUP DE MAIN NPI is 1174451058. The provider is registered as an organization entity type.

The provider's business location address is:

1624 PLAIN AVE NE
CANTON, OH
ZIP 44714-346
Phone: (330) 224-7560

The provider's authorized official is Wanda Jo Mccollum-dotson .
The authorized official title is Director Of Operation and has the following contact phone number (330) 224-7560.

The enumeration date for this NPI number is 5/12/2026 and was last updated on 5/12/2026.

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
1343900000XNon-emergency Medical Transport (VAN)No
2385H00000XRespite CareNo
3385HR2060XRespite CareRespite Care, Intellectual and/or Developmental DisabilitiesNo
4320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

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: 11/21/2025

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