Healthcare Provider Details

I. General information

NPI: 1114868163
Provider Name (Legal Business Name): TEAM RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5217 MONROE ST
TOLEDO OH
43623-4601
US

IV. Provider business mailing address

306 BETTE LN
PORT CLINTON OH
43452-4301
US

V. Phone/Fax

Practice location:
  • Phone: 419-843-9804
  • Fax:
Mailing address:
  • Phone: 419-843-9804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MAEVE MCCARTHY
Title or Position: CASE MANAGER
Credential:
Phone: 440-829-6705