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General NPI Number Information
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NPI Number | 1215468038
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Entity Type | Organization
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Legal Business Name | LEAN IN RECOVERY CENTER
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Dates
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Enumeration Date | 03/23/2017
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 18615 DETROIT AVE STE #207
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City | LAKEWOOD
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State | OH
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Zip | 44107-3274
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Country | US
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Telephone | 216-387-6072
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Fax |
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Provider Business Mailing Address
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Address Line | 18615 DETROIT AVE STE #207
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City | LAKEWOOD
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State | OH
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Zip | 44107-3274
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Country | US
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Telephone | 216-387-6072
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | CARSTEN MCCARTER
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Credential | LCDC II
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Telephone | 216-387-6072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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