CLEAN SLATE SOBER LIVING (NPI# 1902404353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902404353 |
| Entity Type | Organization |
| Organization Name | CLEAN SLATE SOBER LIVING |
| Practice Address |
714 E Main St Trotwood OH 45426-2909 |
| Practice Telephone | 8445487627 |
| Mailing Telephone | 8445487627 |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-11-08 |
| Authorized Official Name | LEILAND WOODS (COO) |
| Authorized Official Telephone | 4047822988 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578101952 | Clean Slate Sober Living | Community/Behavioral Health | 714 E Main St, Trotwood, OH 45426-2909 | 2019-12-16 |
| 1538638218 | Clean Slate Sober Living | Respite Care | 714 E Main St, Trotwood, OH 45426-2909 | 2018-11-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CLEAN SLATE SOBER LIVING, LLC | 714 E Main St, Trotwood, OH 45426-2909 |
| Street Address |
714 E MAIN ST |
| City | TROTWOOD |
| State | OH |
| Zip Code | 45426-2909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295333052 | Clean Slate Sober Living, LLC | Non-emergency Medical Transport (VAN) | 714 E Main St, Trotwood, OH 45426-2909 | 2020-10-14 |
| 1548876931 | Allison Hatton | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2020-09-21 |
| 1861008252 | Kristen Helmick | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2020-09-21 |
| 1013528991 | Brian Davis | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2020-08-13 |
| 1740808393 | Brenda Tannreuther | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2020-07-10 |
| 1285252833 | Zachary Burrell | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2020-07-10 |
| 1831714393 | Brandon T Finch | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2020-06-10 |
| 1184250045 | Leslye Stanford | Counselor | 714 E Main St, Trotwood, OH 45426-2909 | 2020-03-22 |
| 1467091421 | Ryan Cherie Thomas | Counselor | 714 E Main St, Trotwood, OH 45426-2909 | 2019-12-22 |
| 1508404823 | Anthony Tyler Whittington | Case Manager/Care Coordinator | 714 E Main St, Trotwood, OH 45426-2909 | 2019-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841842515 | Gwenivere S Brown | Social Worker | 2580 Shiloh Springs Rd #b, Trotwood, OH 45426 | 2019-07-12 |
| 1790146595 | John Parker Moore | Counselor | 1770 Shiloh Springs Rd., Dayton, OH 45426 | 2016-03-08 |
| 1417336587 | Sisterhomehealthcareprovider | Home Health | 5119 Kingsford Av., Dayton, OH 45426 | 2015-05-22 |
| 1164851846 | Ronica Diene | Licensed Practical Nurse | 5324 Greencroft Dr, Dayton, OH 45426 | 2013-11-04 |
| 1568897783 | Shatonne Dianne Jackson | Nursing Facility/Intermediate Care Facility | 616 Ellsworth Dr, Dayton, OH 45426 | 2013-09-06 |
| 1144570318 | Ja'net D Hines | Licensed Practical Nurse | 12 Greacian Ave, Dayton, OH 45426 | 2012-09-14 |
| 1306106422 | Njek Akieh Achu | Home Health | 5909 Macduff Dr Apt 1716, Trotwood, OH 45426 | 2012-05-22 |
| 1518224963 | Edward Harris | Home Health Aide | 4921 Bloomfield Dr, Apt L, Trotwood, OH 45426 | 2012-04-23 |
| 1508134677 | Cedrick D Parks | Pharmacist | 5371 Salem Ave, Trotwood, OH 45426 | 2011-12-05 |
| 1336476308 | Ziks Family Pharmacy Inc 102 | Pharmacy | 4140 Salem Avenue, Dayton, OH 45426 | 2009-11-11 |
| Find all providers in zip 45426 | ||||
| Taxonomy Code | 343900000X |
| Grouping | Transportation Services |
| Classification | Non-emergency Medical Transport (VAN) |
| A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083260772 | Stephanie Ladon Painter | Non-emergency Medical Transport (VAN) | 9 Lareta St, Trotwood, OH 45426-3007 | 2019-08-18 |
| 1174993620 | Excel Developmental Services | Non-emergency Medical Transport (VAN) | 5351 Wood Creek Rd, Trotwood, OH 45426-1617 | 2015-09-28 |
| 1780947473 | Med Mobile | Non-emergency Medical Transport (VAN) | 100 Prosperity Dr, Trotwood, OH 45426-2600 | 2012-06-19 |
| 1295333052 | Clean Slate Sober Living, LLC | Non-emergency Medical Transport (VAN) | 714 E Main St, Trotwood, OH 45426-2909 | 2020-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386845 | Tijauna Smith | Non-emergency Medical Transport (VAN) | 962 Morningstar Dr, Akron, OH 44307-2208 | 2020-11-05 |
| 1437750429 | Ohio Cares Medical Transportation | Non-emergency Medical Transport (VAN) | 1230 Gabrielle Elaine Dr Apt 303, Columbus, OH 43228-8849 | 2020-11-05 |
| 1023619111 | Madison L Thompson | Non-emergency Medical Transport (VAN) | 2831 E Glenn St, Toledo, OH 43613-1138 | 2020-11-04 |
| 1043811284 | Patricia Baxter Mclaughlin | Non-emergency Medical Transport (VAN) | 466 Rockwood Cir, Peninsula, OH 44264-9537 | 2020-11-04 |
| 1467053710 | Shamika A Gordon | Non-emergency Medical Transport (VAN) | 1074 Valdes Ave, Akron, OH 44320-2636 | 2020-11-03 |
| 1477154094 | Patricia Ann Barton | Non-emergency Medical Transport (VAN) | 622 Clinton St, Sandusky, OH 44870 | 2020-11-02 |
| 1144820713 | Andrew Taylor | Non-emergency Medical Transport (VAN) | 108 Old Colony Dr, Delaware, OH 43015-6502 | 2020-10-31 |
| 1801496617 | Robert Floyd Sams | Non-emergency Medical Transport (VAN) | 1148 Monteray Dr, Akron, OH 44305-1770 | 2020-10-30 |
| 1609476936 | Crystal Cleveland | Non-emergency Medical Transport (VAN) | 898 Township Road 210, Marengo, OH 43334-9623 | 2020-10-27 |
| 1508465006 | Katharine Ware | Non-emergency Medical Transport (VAN) | 10029 Pleasant Lake Blvd Apt P-16, Parma, OH 44130-7549 | 2020-10-26 |
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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.