Organization
MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION
Active
Other names
The MODE- Miracles Occur Days Enriched A Non-Profit Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA LENORA PETRARCA-GAMIDO LICDC, SWA (EXECUTIVE DIRECTOR)
(330) 388-5757
Entity
Organization
Contact information
Practice address
50 BAKER BLVD STE 5A, FAIRLAWN, OH 44333-3603
(330) 388-5757
Mailing address
50 BAKER BLVD STE 5A, FAIRLAWN, OH 44333-3603
(330) 388-5757
(330) 294-1581
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
11/11/2021
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