MOHICAN YOUTH ACADEMY LLC (NPI# 1801208582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801208582 |
| Entity Type | Organization |
| Organization Name | MOHICAN YOUTH ACADEMY LLC |
| Practice Address |
1012 Odnr Mohican 51 Perrysville OH 44864-9407 |
| Practice Telephone | 4199940300 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2018-01-22 |
| Authorized Official Name | WENDY BRUNO (CREDENTIALING) |
| Authorized Official Telephone | 6145564616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
13519 | OH | Residential Treatment Facilities |
| Street Address |
1012 ODNR MOHICAN 51 |
| City | PERRYSVILLE |
| State | OH |
| Zip Code | 44864-9407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386811693 | Andy Leonard | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2008-05-15 |
| 1861093031 | Glynis Anne Haney | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-11-04 |
| 1033724877 | Katie Marie Clever | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-09-09 |
| 1699388769 | Justin Dean Teeters | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-08-28 |
| 1538772231 | Tamara Sue Thomas | Registered Nurse | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2020-08-24 |
| 1992353718 | David Jesse Carroll | Counselor | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2019-08-27 |
| 1114493897 | Hannah Harding | Social Worker | 1012 Odnr Mohican 51, Perrysville, OH 44864 | 2018-10-19 |
| 1730655721 | Young Star Academy | Community/Behavioral Health | 1012 Odnr Mohican 51, Perrysville, OH 44864 | 2018-10-17 |
| 1477034528 | Young Star Academy | Community/Behavioral Health | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2018-08-27 |
| 1063926616 | Mohican Youth Academy | Psychiatry & Neurology | 1012 Odnr Mohican 51, Perrysville, OH 44864-9407 | 2017-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710469267 | Colton Ullman | Student in an Organized Health Care Education/Training Program | 733 State Route 39, Perrysville, OH 44864 | 2018-08-31 |
| 1164847836 | Daniel Charles Hellinger | Nurse Practitioner | 931 Township Road 2506, Perrysville, OH 44864 | 2014-03-04 |
| 1144432717 | Mary Belle Frost | Home Health Aide | 2314 County Rd 775, Perrysville, OH 44864 | 2007-05-04 |
| 1699208926 | Kimberly S Mcfarren | Massage Therapist | 771b State Route 97, Perrysville, OH 44864 | 2017-04-04 |
| 1841521382 | James Grant Hollenbach | Counselor | 771b State Route 97, Perrysville, OH 44864-9501 | 2010-01-22 |
| 1760709984 | Jo-ellen Carpenter | Physical Therapist | 2231 County Road 775, Perrysville, OH 44864-9531 | 2010-04-27 |
| 1568994663 | Courtney Jarvis | Social Worker | 104 Tom Dick and Harry Ln, P.o. Box, Perrysville, OH 44864-9558 | 2017-03-29 |
| 1083744700 | The Perrysville Fire Department | Ambulance | 181 E 3rd St, Perrysville, OH 44864-9569 | 2007-03-06 |
| 1194179945 | Lindsay Joy Extine | Physical Therapy Assistant | 1050 Mowery Rd, Perrysville, OH 44864-9685 | 2016-04-19 |
| 1871797720 | Tamara Sue Griffey | Registered Nurse | 1579 Mowery Rd, Perrysville, OH 44864-9687 | 2007-06-13 |
| Find all providers in zip 44864 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720347818 | New Directions, Inc. | Substance Abuse Rehabilitation Facility | 30800 Chargrin Boulevard, Cleveland, OH 44124 | 2012-05-09 |
| 1447451604 | New Directions, Inc | Substance Abuse Rehabilitation Facility | 2710 Daisy Ave, Cleveland, OH 44109 | 2007-05-29 |
| 1710019112 | Syntaxis Youth Homes, Inc. | Substance Abuse Rehabilitation Facility | 2824 Joyce Ave, Columbus, OH 43211-1793 | 2007-03-12 |
| 1093892853 | Starr Commonwealth | Substance Abuse Rehabilitation Facility | 301 Obetz Road, Columbus, OH 43207 | 2006-11-01 |
| 1336256346 | House of Hope for Alcoholics | Substance Abuse Rehabilitation Facility | 825 Dennison Ave, Columbus, OH 43215-1315 | 2006-08-24 |
| 1114966512 | Geauga County Sheriffs Office | Substance Abuse Rehabilitation Facility | 12450 Merritt Road, Chardon, OH 44024-9010 | 2006-06-05 |
| 1972540037 | Ohio Department of Youth Services | Substance Abuse Rehabilitation Facility | 8101 Dublin Rd, Delaware, OH 43015-8892 | 2006-05-31 |
| 1790753200 | The Way Station, Inc. | Substance Abuse Rehabilitation Facility | 432 W Fifth St, East Liverpool, OH 43920-2467 | 2006-03-09 |
| 1447888912 | Gordrell Enterprises LLC | Substance Abuse Rehabilitation Facility | 2246 S Hamilton Rd Ste 100, Columbus, OH 43232-4317 | 2020-03-31 |
| 1417501305 | Primary Care Solutions of Ohio Incorporated | Substance Abuse Rehabilitation Facility | 500 Madison Ave, Toledo, OH 43604-1222 | 2019-07-29 |
| Find all providers with the same taxonomy | ||||
| City | PERRYSVILLE |
| Zip Code | 44864 |
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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.