Provider Demographics
NPI:1164908067
Name:COMPLETE RECOVERY LLC
Entity Type:Organization
Organization Name:COMPLETE RECOVERY LLC
Other - Org Name:COMPLETE RECOVERY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-273-8400
Mailing Address - Street 1:13001 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2751
Mailing Address - Country:US
Mailing Address - Phone:216-426-6000
Mailing Address - Fax:
Practice Address - Street 1:13001 CEDAR RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2751
Practice Address - Country:US
Practice Address - Phone:216-426-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery CareGroup - Single Specialty