SQUARE ONE HEALTH LLC (NPI# 1568926376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568926376 |
| Entity Type | Organization |
| Organization Name | SQUARE ONE HEALTH LLC |
| Practice Address |
620 W 44th St Ashtabula OH 44004-6812 |
| Practice Telephone | 6027366973 |
| Mailing Telephone | 6027366973 |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |
| Authorized Official Name | JUSTIN D DUFOUR (OWNER) |
| Authorized Official Telephone | 9282311789 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Street Address |
620 W 44TH ST |
| City | ASHTABULA |
| State | OH |
| Zip Code | 44004-6812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649882952 | Marshae Bowens | Counselor | 620 W 44th St, Ashtabula, OH 44004-6812 | 2020-08-18 |
| 1316586399 | Danielle Wittingen | Counselor | 620 W 44th St, Ashtabula, OH 44004-6812 | 2019-12-23 |
| 1689213662 | Christy Fisher | Counselor | 620 W 44th St, Ashtabula, OH 44004-6812 | 2019-12-23 |
| 1619516689 | Sarah M Pace | Counselor | 620 W 44th St, Ashtabula, OH 44004-6812 | 2019-12-23 |
| 1457812943 | Jenelle Ann Morales | Counselor | 620 W 44th St, Ashtabula, OH 44004-6812 | 2019-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174167050 | Jack Lemmon | Physical Therapist | 2515 Lake Rd E, Ashtabula, OH 44004 | 2019-11-04 |
| 1871060608 | Ahmed Shahata | Obstetrics & Gynecology | Ashtabula County Medical Center/obgyn Dept, 2420 Lake Ave, Ashtabula, OH 44004 | 2018-10-30 |
| 1861999013 | Thomas Webber | Counselor | 2801 C. Court, Ashtabula, OH 44004 | 2018-04-12 |
| 1942702428 | Troy Mills | Hearing Instrument Specialist | 2604 West Prospect Rd, Ashtabula, OH 44004 | 2018-03-01 |
| 1598294886 | Howard Edward Loftus Jr. | Counselor | 4726 Main Ave., Ashtabula, OH 44004 | 2017-06-08 |
| 1861928087 | Hannah Woods | Physical Therapist | 3720 N Ridge Road W, Ashtabula, OH 44004 | 2017-05-08 |
| 1376095422 | Lantern of Saybrook | Assisted Living Facility | 3720 North Ridge Road West, Ashtabula, OH 44004 | 2016-10-25 |
| 1801346366 | Melissa Marie Holland | Licensed Practical Nurse | 2124 W Prospect Rd, Ashtabula, OH 44004 | 2016-10-09 |
| 1184080087 | Kevin M Welsh | Speech-Language Pathologist | 2240 Wade Ave, Ashtabula, OH 44004 | 2016-01-07 |
| 1285021709 | David Hefner | Early Intervention Provider Agency | 600 State Road, Ashtabula, OH 44004 | 2015-04-22 |
| Find all providers in zip 44004 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588270128 | Findlay Center for Recovery | Substance Abuse Rehabilitation Facility | 1800 Manor Hill Rd, Findlay, OH 45840-6612 | 2020-09-18 |
| 1093324352 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7745 Ivygate Lane, Cincinnati, OH 45242 | 2020-07-23 |
| 1467060764 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7745 Ivygate Ln, Montgomery, OH 45242-5119 | 2020-07-22 |
| 1265040554 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7172 Pfeiffer Road, Cincinnati, OH 45242 | 2020-07-22 |
| 1144838442 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 10519 Cinderella Drive, Cincinnati, OH 45242 | 2020-07-22 |
| 1114535978 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 4365 Classic Dr, Blue Ash, OH 45241-2205 | 2020-07-17 |
| 1740800077 | Cairn Recovery Resources LLC | Substance Abuse Rehabilitation Facility | 217 Muskingum Ave, Zanesville, OH 43701-4957 | 2020-04-16 |
| 1013543982 | New Life Recovery, LLC | Substance Abuse Rehabilitation Facility | 14761 State Route 93 Unit 4, Jackson, OH 45640-9820 | 2020-03-23 |
| 1104450063 | Quest Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 401 W High St Ste 9, Mount Vernon, OH 43050-2346 | 2020-02-28 |
| 1922638634 | Randall Jay Smith | Substance Abuse Rehabilitation Facility | 1321 S Westwood Dr, Zanesville, OH 43701-5650 | 2020-01-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.