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Organization

RECOVERY IS POSSIBLE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAUNTAP PATRICK (OWNER/LPN)
(419) 215-4131
Entity
Organization

Contact information

Practice address
757 PROUTY AVE, TOLEDO, OH 43609-3331
(419) 215-4131
Mailing address
757 PROUTY AVE, TOLEDO, OH 43609-3331
(419) 215-4131

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
251B00000X
Case Management Agency
261QR0800X
Recovery Care Clinic/Center
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
05/09/2023
Last updated
05/09/2023
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