Provider Demographics
NPI:1811197791
Name:ADAPTIVE RESOURCES & CONSULTING INC
Entity Type:Organization
Organization Name:ADAPTIVE RESOURCES & CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:330-722-4000
Mailing Address - Street 1:3035 MARLA CT
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8797
Mailing Address - Country:US
Mailing Address - Phone:330-722-4000
Mailing Address - Fax:330-722-7686
Practice Address - Street 1:3035 MARLA CT
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8797
Practice Address - Country:US
Practice Address - Phone:330-722-4000
Practice Address - Fax:330-722-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9344941OtherMEDICARE LEGACY #
OH0208671Medicaid
OH9344941Medicare PIN