Healthcare Provider Details

I. General information

NPI: 1982530143
Provider Name (Legal Business Name): ROOTED RECOVERY SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 ENGLE RD STE I
MIDDLEBURG HEIGHTS OH
44130-7930
US

IV. Provider business mailing address

6801 ENGLE RD STE I
MIDDLEBURG HEIGHTS OH
44130-7930
US

V. Phone/Fax

Practice location:
  • Phone: 440-517-4700
  • Fax: 440-517-4700
Mailing address:
  • Phone: 440-517-4700
  • Fax: 440-517-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS LUMSDEN
Title or Position: PHYSICIAN ASSISTANT
Credential: PA
Phone: 440-454-5416