MEDICARE: BROADWAY RECOVERY SERVICES, INC.

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
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1861017683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROADWAY RECOVERY SERVICES, INC.

Provider Business Mailing Address
First Line	:	7025 MARKET ST
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-4510
Country	:	US
Telephone Number	:	855-292-9778
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 WILLIAMSON AVE
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44507-1226
Country	:	US
Telephone Number	:	855-292-9778
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ADAM LONARDO
Credential	:
Telephone Number	:	855-292-9778

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	05/06/2026

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