Provider Demographics
NPI:1508621616
Name:NORTHEASTERN OHIO RECOVERY ASSOCIATION
Entity Type:Organization
Organization Name:NORTHEASTERN OHIO RECOVERY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH TECHNITION
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WEIDUS
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:216-727-5663
Mailing Address - Street 1:1400 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1304
Mailing Address - Country:US
Mailing Address - Phone:216-391-6672
Mailing Address - Fax:
Practice Address - Street 1:17825 LIBBY RD
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1509
Practice Address - Country:US
Practice Address - Phone:216-369-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst