Healthcare Provider Details

I. General information

NPI: 1003619982
Provider Name (Legal Business Name): AUGUST RESIDENTIAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5213 CATHERINE ST
MAPLE HEIGHTS OH
44137-1405
US

IV. Provider business mailing address

5213 CATHERINE ST
MAPLE HEIGHTS OH
44137-1405
US

V. Phone/Fax

Practice location:
  • Phone: 216-270-9927
  • Fax:
Mailing address:
  • Phone: 216-270-9927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JONES
Title or Position: CEO
Credential: DOO
Phone: 216-270-9927