SILVER MAPLE RECOVERY, LLC (NPI# 1124597182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124597182 |
Entity Type | Organization |
Organization Name | SILVER MAPLE RECOVERY, LLC |
Practice Address |
2101 All Pro Athletic Ave Lorain OH 44053-2380 |
Mailing Address |
3905 Oberlin Ave Lorain OH 44053-2853 |
Practice Telephone | 4409895200 |
Mailing Telephone | 4409895238 |
Mailing Fax Number | 4409894362 |
Enumeration Date | 2018-11-20 |
Last Update Date | 2018-11-20 |
Authorized Official Name | SUE E WIEDENMANNOTT (MEDICARE COORDINATOR) |
Authorized Official Telephone | 4409895238 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | SILVER MAPLE RECOVERY, LLC | 2101 All Pro Athletic Ave, Lorain, OH 44053-2380 |
Street Address |
2101 ALL PRO ATHLETIC AVE |
City | LORAIN |
State | OH |
Zip Code | 44053-2380 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386242196 | Yokita Maria Thomas | Homemaker | 4818 Ashland Ave, Lordin, OH 44053 | 2020-10-14 |
1497353445 | Matthew George Simkovich | Homemaker | 4366 Jenee Dr, Lorain, OH 44053 | 2020-10-13 |
1881229979 | Christine Wilson | Physical Therapist | 5940 Oak Point Rd., Lorain, Lorain, OH 44053 | 2020-03-09 |
1912538760 | Barry Delaney Masin | Student in an Organized Health Care Education/Training Program | 2704 West Erie Avenue, Lorain, OH 44053 | 2020-01-30 |
1275171399 | Martina Beato | Social Worker | The Nord Center 6140 S. Broadway, Lorain, OH 44053 | 2019-12-19 |
1285279802 | Tivan LLC | Non-emergency Medical Transport (VAN) | 5821 Williamsburg Dr., Lorain, OH 44053 | 2019-11-07 |
1023650843 | Candace Taber | Case Manager/Care Coordinator | 6140 South Broadway, Lorain, OH 44053 | 2019-10-14 |
1265956098 | Phillip H Emerson | Social Worker | 1740 Cooper Foster Park Road East, Lorain, OH 44053 | 2017-08-02 |
1447796750 | Kafilat Idowu Kelani | Nurse Practitioner | 3700 Kolbe Rd, Lorain, Lorain, OH 44053 | 2017-01-10 |
1083075808 | Mark B Applegate | Counselor | 2115 West Park Drive, Lorain, OH 44053 | 2016-03-08 |
Find all providers in zip 44053 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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1669942934 | Baymark Health Services of Ohio | Clinic/Center | 833 E Broad St Unit 1, Elyria, OH 44035-6557 | 2018-11-29 |
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Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.