OrganizationActive
Madison Village Manor, Inc
NPI 1154504983 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Madison, OH
Provider details
- NPI number
- 1154504983
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Madison Village Manor, Inc
- Organization subpart
- Yes
- Authorized official
- Anthony Serra, Administrator(440) 428-1519
- License
- 4310178 (OH)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 4310178 (OH)
Residential Treatment Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
731 N Lake St
Madison, OH 44057-3152
Phone: (440) 428-1519
Fax: (440) 428-6360
Street-level locationGet directions
Mailing address
Po Box 272
Madison, OH 44057-0272
Other names (DBA / former)
- Doing business as
- The Gables
Registry dates
- Enumerated
- 2007-12-15
- Last updated
- 2007-12-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.