CHARISSE ALI, LLC A LASTING IMPRESSION – NPI #1063008670
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

CHARISSE ALI, LLC A LASTING IMPRESSION is a community based residential treatment facility located in ASHTABULA, OH. NPPES has assigned the NPI number 1063008670 to CHARISSE ALI, LLC A LASTING IMPRESSION on December 17, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHARISSE ALI, LLC A LASTING IMPRESSION below.

NPI Profile for
CHARISSE ALI, LLC A LASTING IMPRESSION

NPI Number
1063008670
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHARISSE ALI, LLC A LASTING IMPRESSION
Primary location
1440 W PROSPECT RD
ASHTABULA, OH 44004-6668
Phone: (440) 319-2078 Fax: (440) 998-5820
Mailing address
PO BOX 548
ASHTABULA, OH 44005-0548
Phone: (440) 319-2078 Fax: (440) 998-5820
Organization Subpart
No
Authorized Official
CHARISSE ALI
CEO/OWNER
Phone: (440) 319-2078
Updated
Certification Date
Dec 17, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.