Healthcare Provider Details

I. General information

NPI: 1588497960
Provider Name (Legal Business Name): A POSH RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17325 EUCLID AVE
CLEVELAND OH
44112-1247
US

IV. Provider business mailing address

17325 EUCLID AVE
CLEVELAND OH
44112-1247
US

V. Phone/Fax

Practice location:
  • Phone: 440-742-6002
  • Fax:
Mailing address:
  • Phone: 440-742-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SONIA YVETTE LOCKETT
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 440-742-6002