Organization
BRI RAE SOBER LIVING AND ADDICTION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAKITA BROCK-DARLING (PRESIDENT)
(216) 270-9101
Entity
Organization
Contact information
Practice address
1256 MELBOURNE RD, EAST CLEVELAND, OH 44112-4137
(216) 868-5182
Mailing address
900 CHINABERRY CIR S, MACEDONIA, OH 44056-2324
(216) 270-9101
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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