SHALOM HOUSE SOUTH (NPI# 1912961806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912961806 |
| Entity Type | Organization |
| Organization Name | SHALOM HOUSE SOUTH |
| Other Organization Name | SHALOM HOUSE INC |
| Practice Address |
1480 College Ave Columbus OH 43209-2888 |
| Practice Telephone | 6143382351 |
| Practice Fax Number | 6143382353 |
| Mailing Telephone | 6143382351 |
| Mailing Fax Number | 6143382353 |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. RUTH DODGE (ADMINISTRATOR) |
| Authorized Official Telephone | 6142391999 |
| Authorized Official Credential | QMRP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 2512963 | OH | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0899201 | 05 |
| Other Name | Type Code |
|---|---|
| Shalom House Inc | Doing Business As Name - Organization |
| Street Address |
1480 COLLEGE AVE |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43209-2888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649767062 | Rem Ohio Inc | Intermediate Care Facility, Mentally Retarded | 1480 College Ave, Columbus, OH 43209-2888 | 2018-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070280 | Abu Daniel Kamara | Case Manager/Care Coordinator | 2935 E Main St 9721, Columbus, OH 43209 | 2020-10-15 |
| 1407482771 | Anew Life Treatment and Training Center, LLC | Social Worker | 509 N Cassady Ave #201, Bexley, OH 43209 | 2020-03-19 |
| 1225661986 | Partners In Recovery Inc | Clinic/Center | 1925 E. Livingston Ave, Suite 403, Columbus, OH 43209 | 2020-02-20 |
| 1437798451 | Next Generation Behavioral Health | Psychologist | 2256 1/2 E Main St, Suite C, Bexley, OH 43209 | 2019-12-23 |
| 1730692773 | River Vista Health and Wellness LLC | Psychiatric Hospital | 1599 Alum Creek Drive, Columbus, OH 43209 | 2017-11-13 |
| 1235659541 | Barrier Free Environments of Ohio | In Home Supportive Care | 411 S Broadleigh, Columbus, OH 43209 | 2017-06-27 |
| 1679005698 | Jonathan Smith | Counselor | 360 Grant Ave, Columbus, OH 43209 | 2017-03-29 |
| 1033650858 | Latasha Michelle Gates | Licensed Practical Nurse | 2917 Eastmoreland Dr, Columbus, OH 43209 | 2017-03-13 |
| 1568817427 | Family First Home Health LLC | Clinic/Center | 526 N. Cassady Avenue, Bexley, OH 43209 | 2016-04-28 |
| 1750782454 | Karen Marie Haley | Home Health Aide | 305 N. Gould Rd, Apt #3, Columbus, OH 43209 | 2014-09-12 |
| Find all providers in zip 43209 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053865568 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 2433 Teakwood Dr, Columbus, OH 43229-9328 | 2016-08-12 |
| 1386197929 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 1382 Ida Ave, Columbus, OH 43212-2908 | 2016-08-01 |
| 1053864694 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 4171 Maize Rd, Columbus, OH 43224-1951 | 2016-08-01 |
| 1376096909 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 2357 Hampstead Dr, Columbus, OH 43229-2852 | 2016-08-01 |
| 1619420254 | Hattie Larlham Center for Children With Disabilities | Intermediate Care Facility, Mentally Retarded | 3860 Kimberly Pkwy N, Columbus, OH 43232-4267 | 2016-08-01 |
| 1265629448 | Voca Corporation of Ohio | Intermediate Care Facility, Mentally Retarded | 340 Derrer Rd, Columbus, OH 43204-1127 | 2007-10-01 |
| 1114127743 | Rescare Ohio Inc.. | Intermediate Care Facility, Mentally Retarded | 4133 Karl Rd, Columbus, OH 43224-2054 | 2007-07-22 |
| 1881802254 | Franklin County Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 4410 Morse Rd, Columbus, OH 43230-1382 | 2007-05-18 |
| 1174731996 | Residential Options, Inc | Intermediate Care Facility, Mentally Retarded | 3273 Shasta Ave, Columbus, OH 43231-3160 | 2007-05-18 |
| 1578771911 | Franklin County Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 5684 Dierker Rd, Columbus, OH 43235-7114 | 2007-05-18 |
| Find all providers in COLUMBUS | ||||
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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.