Healthcare Provider Details

I. General information

NPI: 1407783558
Provider Name (Legal Business Name): LIFE FLOW RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 BURNHAM AVE APT 1
TOLEDO OH
43612-1999
US

IV. Provider business mailing address

4225 BURNHAM AVE APT 1
TOLEDO OH
43612-1999
US

V. Phone/Fax

Practice location:
  • Phone: 567-297-0770
  • Fax:
Mailing address:
  • Phone: 567-297-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DEVON ALEXANDER FITZPATRICK
Title or Position: CEO
Credential: LSW
Phone: 567-297-0770