Organization
MIDWEST DETOX CENTER LLC
Active
Parent organization
MIDWEST DETOX CENTER LLC
Other names
Ohio Detox Center, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST DETOX CENTER LLC
Authorized official
ALLISON HEABERLIN (CREDENTIALING SPECIALIST)
(410) 415-3385
Entity
Organization
Contact information
Practice address
1757 INDIAN WOOD CIR, MAUMEE, OH 43537-4009
(833) 440-8642
Mailing address
10461 MILL RUN CIR STE 810, OWINGS MILLS, MD 21117-5549
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0281740
—
OH
Enumeration date
07/02/2019
Last updated
01/12/2024
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