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NPI Code Detail

MEDICARE: STANDING IN THE GAP LLC

MEDICARE: STANDING IN THE GAP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1164145702
Entity Type Code : Organization
Provider Name (Legal Business Name) : STANDING IN THE GAP LLC
Provider Business Mailing Address
First Line : 525 JEFFERSON AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43604-1094
Country : US
Telephone Number : 419-360-8251
Fax Number : 888-422-8961
Provider Business Practice Location Address
First Line : 500 MADISON AVE STE 340
Second Line :
City : TOLEDO
State : OH
Zip : 43604-1277
Country : US
Telephone Number : 419-360-8251
Fax Number : 888-422-8961
Authorized Official
Title or Position : CEO
Name : ARLENE FORD-BOND
Credential : RN
Telephone Number : 419-356-1465
Provider Enumeration Date : 09/20/2022
Last Update Date : 09/20/2022

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Directions to “STANDING IN THE GAP LLC ” Practice Location

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