Organization
BEECH BROOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA REX M.ED. (CHIEF EXECUTIVE OFFICER)
(216) 831-2255
Entity
Organization
Contact information
Practice address
11801 BUCKEYE RD, CLEVELAND, OH 44120-2620
(216) 831-2255
(216) 831-0436
Mailing address
3737 LANDER RD, PEPPER PIKE, OH 44124-5712
(216) 831-2255
(216) 831-0436
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
12773
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12773
OHIO DEPARTMENT OF ALCOHOL AND DRUG ADDICTION SERVICES
OR
Enumeration date
03/04/2009
Last updated
03/04/2009
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