Organization
MIDWEST RECOVERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BROWN (DIRECTOR OF COMPLIANCE)
(870) 243-7219
Entity
Organization
Contact information
Practice address
4747 MONROE ST, TOLEDO, OH 43623-4307
(833) 654-1029
Mailing address
10461 MILL RUN CIR STE 810, OWINGS MILLS, MD 21117-5549
(866) 203-0308
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0309004
—
OH
05
—
0326341
—
OH
Enumeration date
07/03/2017
Last updated
03/11/2024
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