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NPI 1275091795

NPI 1275091795 : SYMETRIA HEALTH OF OHIO, L.L.C. : SHEFFIELD VILLAGE, OH

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General NPI Number Information
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    NPI Number           |    1275091795
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    Entity Type          |    Organization 
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    Legal Business Name  |    SYMETRIA HEALTH OF OHIO, L.L.C. 
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Dates
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    Enumeration Date     |    03/04/2019
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    Last Update Date     |    03/18/2019
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Provider Practice Location Address
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    Address Line         |    5445 DETROIT RD 
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    City                 |    SHEFFIELD VILLAGE
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    State                |    OH
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    Zip                  |    44054-3909
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    Country              |    US
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    Telephone            |    888-782-6966
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    Fax                  |    630-870-1284
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Provider Business Mailing Address
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    Address Line         |    40 SHUMAN BLVD STE 262 
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    City                 |    NAPERVILLE
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    State                |    IL
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    Zip                  |    60563-8480
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    Country              |    US
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    Telephone            |    888-782-6966
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    Fax                  |    630-870-1284
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Authorized Official
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    Title or Position    |    CHIEF EXECUTIVE OFFICER
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    Name                 |     CHRIS  HASSON 
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    Credential           |    
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    Telephone            |    888-782-6966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QR0405X
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    Taxonomy Name        |    Substance Use Disorder Rehabilitation Clinic/Center
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    License Number       |    
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    License Number State |    
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