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General NPI Number Information
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NPI Number | 1598581274
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Entity Type | Organization
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Legal Business Name | SILVER MAPLE RECOVERY LLC
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 2101 SILVER MAPLE WAY
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City | LORAIN
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State | OH
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Zip | 44053-2380
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Country | US
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Telephone | 440-830-3400
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Fax | 440-830-3416
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Provider Business Mailing Address
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Address Line | 2101 SILVER MAPLE WAY
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City | LORAIN
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State | OH
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Zip | 44053-2380
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Country | US
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Telephone | 440-830-3400
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Fax | 440-830-3416
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Authorized Official
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Title or Position | RESIDENT COORDINATOR
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Name | MR. MATTHEW HAWKINS
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Credential | LCDC II
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Telephone | 440-241-7917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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