| Northern Ohio Recovery Association | |
|
3746 Prospect Ave E Cleveland OH 44115-2706 | |
| (216) 391-6672 | |
| (216) 391-4633 |
| Full Name | Northern Ohio Recovery Association |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3746 Prospect Ave E, Cleveland, Ohio |
| Authorized Official Name and Position | Anita Bradley (CEO) |
| Authorized Official Contact | 2163916672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Ohio Recovery Association 3746 Prospect Ave E Cleveland OH 44115-2706 Ph: (216) 391-6672 | Northern Ohio Recovery Association 3746 Prospect Ave E Cleveland OH 44115-2706 Ph: (216) 391-6672 |
| NPI Number | 1952447393 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 11/24/2021 |
| Certification Date | 11/24/2021 |
| Medicare PECOS PAC ID | 0345647921 |
|---|---|
| Medicare Enrollment ID | O20210923003467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952447393 | NPI | - | NPPES |
| 12379 | Other | OH | 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 12603 (Ohio) | Primary |
| Provider Name | Sheneka Mcgee-fears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932725363 PECOS PAC ID: 5092133926 Enrollment ID: I20200909002598 |
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