1003832452 NPI number — RESCUE INCORPORATED

Table of content: (NPI 1003832452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003832452 NPI number — RESCUE INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESCUE INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RESCUE MENTAL HEALTH SERVICES
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003832452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3350 COLLINGWOOD BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43610-1173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-255-9585
Provider Business Mailing Address Fax Number:
419-255-0207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3350 COLLINGWOOD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43610-1173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-255-9585
Provider Business Practice Location Address Fax Number:
419-255-3477
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KARASEK
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
P
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
419-255-5262

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  RF032019 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: RF032020 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 324500000X , with the licence number: RF032020 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 343800000X , with the licence number: RF032020 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1350 . This is a "MACSIS UPI" identifier . This identifiers is of the category "OTHER".




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