Provider Demographics
NPI:1558016543
Name:MERIDIAN RECOVERY LLC
Entity type:Organization
Organization Name:MERIDIAN RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHTINEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-488-9594
Mailing Address - Street 1:11835 W OLYMPIC BLVD STE 815E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-5056
Mailing Address - Country:US
Mailing Address - Phone:323-332-9905
Mailing Address - Fax:
Practice Address - Street 1:11835 W OLYMPIC BLVD STE 815E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5056
Practice Address - Country:US
Practice Address - Phone:323-332-9905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-17
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder