TRAVCO REHABILITATION CENTER, INC. (NPI# 1881687085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881687085 |
| Entity Type | Organization |
| Organization Name | TRAVCO REHABILITATION CENTER, INC. |
| Practice Address |
4030 Boardman Canfield Rd Suite 200c Canfield OH 44406-9505 |
| Practice Telephone | 3302860050 |
| Practice Fax Number | 3302860055 |
| Mailing Telephone | 3302860050 |
| Mailing Fax Number | 3302860055 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. SCOTT THOMAS GORLEY (PRESIDENT) |
| Authorized Official Telephone | 3302860050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
364511 | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2143620 | 05 |
| Street Address |
4030 BOARDMAN CANFIELD RD SUITE 200C |
| City | CANFIELD |
| State | OH |
| Zip Code | 44406-9505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821438730 | Jaymi Lynn Wendt | Social Worker | 4030 Boardman Canfield Rd, Canfield, OH 44406-9505 | 2013-06-25 |
| 1134484348 | Katherine Feather | Counselor | 4030 Boardman Canfield Rd, Suite 200c, Canfield, OH 44406-9505 | 2012-07-13 |
| 1437418001 | Travco Behavioral Health, Inc. | Community/Behavioral Health | 4030 Boardman Canfield Rd, Suite 200c, Canfield, OH 44406-9505 | 2012-05-16 |
| 1255604971 | Pedro Martinez | Counselor | 4030 Boardman Canfield Rd, Suite 200c, Canfield, OH 44406-9505 | 2012-02-10 |
| 1972647097 | Bury Chiropractic and Wellness Center | Chiropractor | 4030 Boardman Canfield Rd, Suite # 100c, Canfield, OH 44406-9505 | 2007-02-20 |
| 1467598987 | Cynthia Ann Kruzel-o'keefe | Counselor | 4030 Boardman Canfield Rd, Suite 200c, Canfield, OH 44406-9505 | 2007-01-30 |
| 1124086616 | Travco Behavioral Health, Inc. | Case Management | 4030 Boardman Canfield Rd, Suite 200c, Canfield, OH 44406-9505 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952802282 | Julie Nicole Austalosh | Case Manager/Care Coordinator | 3711 Indian Run Dr Apt 7, Canfield, OH 44406 | 2018-02-22 |
| 1073064887 | Abby Smith | Specialist/Technologist | 250 Lake Pointe Circle, Canfield, OH 44406 | 2016-10-17 |
| 1255887949 | Chris Smallwood II | Driver | 6128 St Andrews Dr, Canfield, OH 44406 | 2016-09-01 |
| 1831572064 | Gateways To Better Living | Intermediate Care Facility, Mentally Retarded | 41 Talsman Drive, Youngstown, OH 44406 | 2015-07-07 |
| 1568845790 | Gateways To Better Living | Intermediate Care Facility, Mentally Retarded | 3222 Forty Second Street, Youngstown, OH 44406 | 2015-07-07 |
| 1003212051 | Diane Pool | Registered Nurse | 100 Wadsworth Street, Canfield, OH 44406 | 2014-11-18 |
| 1215353990 | Jeanne Siverd | Occupational Therapy Assistant | 11300 Columbiana-canfield Rd., Suite E, Canfield, OH 44406 | 2014-03-05 |
| 1134565641 | Dema Halasa Esper | Dietitian, Registered | 52 Timber Run Dr., Canfield, OH 44406 | 2013-05-13 |
| 1851680615 | Kimberly Jean Fyock | Licensed Practical Nurse | 7720 Lydia Ln, Canfield, OH 44406 | 2011-04-01 |
| 1205060654 | Jennifer L Morris | Registered Nurse | 3787 Mercedes Place, Canfield, OH 44406 | 2009-05-13 |
| Find all providers in zip 44406 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
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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.