Provider Demographics
NPI:1225573090
Name:OHIO ADDICTION RECOVERY CENTER
Entity Type:Organization
Organization Name:OHIO ADDICTION RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SACKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-481-8457
Mailing Address - Street 1:3880 JACKPOT RD
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-7500
Mailing Address - Country:US
Mailing Address - Phone:614-594-3988
Mailing Address - Fax:
Practice Address - Street 1:3880 JACKPOT RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-7500
Practice Address - Country:US
Practice Address - Phone:614-594-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility