Provider Demographics
NPI:1265023592
Name:RACING FOR RECOVERY
Entity Type:Organization
Organization Name:RACING FOR RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDERMEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-708-0841
Mailing Address - Street 1:6202 TRUST DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8425
Mailing Address - Country:US
Mailing Address - Phone:419-824-8462
Mailing Address - Fax:
Practice Address - Street 1:6202 TRUST DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-8425
Practice Address - Country:US
Practice Address - Phone:419-824-8462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty