Provider Demographics
NPI: | 1780300566 |
---|---|
Name: | CARE RECOVERY, LLC |
Entity type: | Organization |
Organization Name: | CARE RECOVERY, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ADAM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CUSNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD |
Authorized Official - Phone: | 740-338-2273 |
Mailing Address - Street 1: | 4345 BAINTREE RD |
Mailing Address - Street 2: | |
Mailing Address - City: | UNIVERSITY HEIGHTS |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44118-3930 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 740-338-2273 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4345 BAINTREE RD |
Practice Address - Street 2: | |
Practice Address - City: | UNIVERSITY HEIGHTS |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44118-3930 |
Practice Address - Country: | US |
Practice Address - Phone: | 781-608-1487 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | EARTH, LLC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2022-10-13 |
Last Update Date: | 2022-11-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 101200000X | Behavioral Health & Social Service Providers | Drama Therapist | Group - Multi-Specialty | |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
No | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Multi-Specialty |
No | 102L00000X | Behavioral Health & Social Service Providers | Psychoanalyst | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty |