# UNIVERSAL TREATMENT AND RECOVERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013011238
- **Authorized official:** DR. GARY ALLAN VAN SKYHOCK DC (MEMBER)
- **Authorized official phone:** (440) 324-4488

## Contact information

- **Practice address:** 42553 NORTH RIDGE ROAD, SUITE 8, ELYRIA, OH 44035
- **Practice address phone:** (440) 324-4488
- **Practice address fax:** (440) 324-2465
- **Mailing address:** 42553 NORTH RIDGE ROAD, SUITE 8, ELYRIA, OH 44035
- **Mailing address phone:** (440) 324-4488
- **Mailing address fax:** (440) 324-2465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 1467 | OH | Yes |
| 111N00000X | Chiropractor | 3541 | OH | — |
| 111NR0400X | Rehabilitation Chiropractor | — | — | — |
| 207Q00000X | Family Medicine Physician | 34004082 | OH | — |

## Other

- **Enumeration date:** 09/08/2006
- **Last updated:** 01/24/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2948369 | — | OH |