Healthcare Provider Details

I. General information

NPI: 1275235103
Provider Name (Legal Business Name): ADDICTION WELLNESS CENTER OH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 CARSKADDON AVE
TOLEDO OH
43606-1601
US

IV. Provider business mailing address

1100 BUSINESS PKWY S STE 1
WESTMINSTER MD
21157-3048
US

V. Phone/Fax

Practice location:
  • Phone: 667-367-8357
  • Fax:
Mailing address:
  • Phone: 419-917-6796
  • Fax: 419-715-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: RACHEL SAGI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 419-917-6796