Healthcare Provider Details

I. General information

NPI: 1619692332
Provider Name (Legal Business Name): BROADWAY RECOVERY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2022
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 WILLIAMSON AVE
YOUNGSTOWN OH
44507-1226
US

IV. Provider business mailing address

7025 MARKET ST
YOUNGSTOWN OH
44512-4510
US

V. Phone/Fax

Practice location:
  • Phone: 855-292-9778
  • Fax:
Mailing address:
  • Phone: 855-292-9778
  • 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: ADAM LONARDO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 855-292-9778