Organization
INTERVAL BROTHERHOOD HOMES, INC.
Active
Other names
IBH Addiction Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY HENDERSON JR. (CFO)
(330) 237-6878
Entity
Organization
Contact information
Practice address
3445 S MAIN ST, COVENTRY TWP, OH 44319-3028
(330) 644-4095
(330) 645-2031
Mailing address
3445 S MAIN ST, COVENTRY TWP, OH 44319-3028
(330) 644-4095
(330) 645-2031
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
1505
OH
Other
Enumeration date
10/03/2006
Last updated
04/23/2025
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