Provider Demographics
NPI:1982223657
Name:RECREA HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:RECREA HEALTH AND WELLNESS LLC
Other - Org Name:THE DAHLIA CENTER, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-802-3868
Mailing Address - Street 1:3637 MEDINA RD STE 85
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8153
Mailing Address - Country:US
Mailing Address - Phone:330-952-0391
Mailing Address - Fax:
Practice Address - Street 1:2425 MEDINA RD STE 101
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5381
Practice Address - Country:US
Practice Address - Phone:330-952-0391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty