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NPI Code Detail

MEDICARE: NORTHERN OHIO RECOVERY ASSOCIATION

MEDICARE: NORTHERN OHIO RECOVERY ASSOCIATION
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
1251S00000XCommunity/Behavioral Health Agency12603OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112379OTHEROH1

General Provider Information

NPI Number : 1952447393
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHERN OHIO RECOVERY ASSOCIATION
Provider Business Mailing Address
First Line : 3746 PROSPECT AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2706
Country : US
Telephone Number : 216-391-6672
Fax Number : 216-391-4633
Provider Business Practice Location Address
First Line : 1400 E 55TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-1304
Country : US
Telephone Number : 216-391-6672
Fax Number : 216-391-4633
Authorized Official
Title or Position : CEO
Name : ANITA BRADLEY
Credential :
Telephone Number : 216-391-6672
Provider Enumeration Date : 01/30/2007
Last Update Date : 04/23/2026

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Directions to “NORTHERN OHIO RECOVERY ASSOCIATION ” Practice Location

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