Healthcare Provider Details

I. General information

NPI: 1164304499
Provider Name (Legal Business Name): HUMILITY OF MARY HOUSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 COPLEY RD
AKRON OH
44320-2704
US

IV. Provider business mailing address

421 GRAHAM RD STE I
CUYAHOGA FALLS OH
44221-1344
US

V. Phone/Fax

Practice location:
  • Phone: 330-835-9686
  • Fax: 330-835-9643
Mailing address:
  • Phone: 330-384-1555
  • Fax: 330-384-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. FREDERICK A BERRY
Title or Position: PRESIDENT/CEO
Credential:
Phone: 234-525-6404