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NPI Code Detail

MEDICARE: COMMUNITY ORIENTED RECOVERY

MEDICARE: COMMUNITY ORIENTED RECOVERY
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3175T00000XPeer Specialist
4251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101-7778OTHEROHOHIO MENTAL HEALTH AND ADDICTION SERVICES (OMHAS)

General Provider Information

NPI Number : 1639727936
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY ORIENTED RECOVERY
Provider Business Mailing Address
First Line : 640 N MAIN ST
Second Line :
City : AKRON
State : OH
Zip : 44310-3017
Country : US
Telephone Number : 330-625-4711
Fax Number :
Provider Business Practice Location Address
First Line : 640 N MAIN ST
Second Line :
City : AKRON
State : OH
Zip : 44310-3017
Country : US
Telephone Number : 330-625-4711
Fax Number :
Authorized Official
Title or Position : CO-FOUNDER
Name : MR. CORY D EASTGATE
Credential :
Telephone Number : 330-815-1551
Provider Enumeration Date : 08/29/2019
Last Update Date : 07/29/2025

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Directions to “COMMUNITY ORIENTED RECOVERY ” Practice Location

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