Healthcare Provider Details

I. General information

NPI: 1588173223
Provider Name (Legal Business Name): RIVER IOP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 CHESTNUT ST
ELYRIA OH
44035-5325
US

IV. Provider business mailing address

202 CHESTNUT ST
ELYRIA OH
44035-5325
US

V. Phone/Fax

Practice location:
  • Phone: 440-954-4611
  • Fax:
Mailing address:
  • Phone: 216-440-4803
  • Fax: 216-763-9598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN LOMBARDO
Title or Position: CEO
Credential:
Phone: 216-440-4803