MEDICARE: RECOVERY SOLUTIONS OF NORTHEAST OHIO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1275272346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERY SOLUTIONS OF NORTHEAST OHIO

Provider Business Mailing Address
First Line	:	22639 EUCLID AVE
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44117-1622
Country	:	US
Telephone Number	:	216-404-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 E 120TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1456
Country	:	US
Telephone Number	:	216-404-1900
Fax Number	:

Authorized Official
Title or Position	:	EXECUITVE DIRECTOR
Name	:	DR. MARTINA S MOORE
Credential	:	LPCC-S LICDC-CS CEAP
Telephone Number	:	216-404-1900

Provider Enumeration Date	:	05/27/2022
Last Update Date	:	05/27/2022

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Directions to “RECOVERY SOLUTIONS OF NORTHEAST OHIO ” Practice Location

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