Provider Demographics
NPI:1003832452
Name:RESCUE INCORPORATED
Entity Type:Organization
Organization Name:RESCUE INCORPORATED
Other - Org Name:RESCUE MENTAL HEALTH SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:KARASEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-255-5262
Mailing Address - Street 1:3350 COLLINGWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43610-1173
Mailing Address - Country:US
Mailing Address - Phone:419-255-9585
Mailing Address - Fax:419-255-0207
Practice Address - Street 1:3350 COLLINGWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43610-1173
Practice Address - Country:US
Practice Address - Phone:419-255-9585
Practice Address - Fax:419-255-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRF032019322D00000X
OHRF032020323P00000X, 324500000X, 343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1350OtherMACSIS UPI
OH9923052Medicare ID - Type Unspecified