MIDWEST DETOX CENTER LLC (NPI# 1003337734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003337734 |
Entity Type | Organization |
Organization Name | MIDWEST DETOX CENTER LLC |
Practice Address |
1757 Indian Wood Cir Ste A Maumee OH 43537-4009 |
Mailing Address |
6494 La Gorce Ln Lake Worth FL 33463-7379 |
Practice Telephone | 8662030308 |
Mailing Telephone | 8662030308 |
Enumeration Date | 2017-07-03 |
Last Update Date | 2020-10-29 |
Authorized Official Name | MR. MICHAEL SILBERMAN (CEO) |
Authorized Official Telephone | 4108078471 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033608195 | Midwest Detox Center LLC | Substance Abuse Rehabilitation Facility | 1757 Indian Wood Cir, Maumee, OH 43537-4009 | 2018-05-04 |
1356903058 | Midwest Detox Center LLC | Clinic/Center | 1757 Indian Wood Cir, Maumee, OH 43537-4009 | 2019-07-02 |
Street Address |
1757 INDIAN WOOD CIR STE A |
City | MAUMEE |
State | OH |
Zip Code | 43537-4009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245884709 | Mary Walasinski | Behavior Technician | 1900 Indian Wood Circle Suite 100, Maumee, OH 43537 | 2019-08-01 |
1912483314 | Integrated Restorative Solutions LLC | Pain Medicine | 2718 River Rd, Maumee, OH 43537 | 2018-07-18 |
1326533373 | Michelle Lei Sandwisch | Nurse Practitioner | 7140 Maumee Western Road, Maumee, OH 43537 | 2018-06-22 |
1669978201 | Bradley D Walker | Case Manager/Care Coordinator | 1600 Michigan Ave, Maumee, OH 43537 | 2018-04-03 |
1841792306 | Stephen Flory | Specialist/Technologist | 2584 S Detroit Ave, Maumee, OH 43537 | 2018-03-01 |
1851841787 | Michelle Laver | Social Worker | 7320 Sh 108, Wauseon, OH 43537 | 2016-10-04 |
1083070288 | Friends Who Care | Home Health | 2749 Pine Trace Dr, Maumee, OH 43537 | 2016-01-05 |
1386025203 | Unique Health Care Solutions, LLC | Home Health | 3430 Briarfield Blvd, Maumee, OH 43537 | 2015-06-16 |
1104239698 | Jill Saul | Dietitian, Registered | 5871 Monclova Rd., Maumee, OH 43537 | 2014-06-03 |
1922438910 | Kristen Junga | Counselor | 1627 Henthorne Dr Ste E, Maumee, OH 43537 | 2013-11-12 |
Find all providers in zip 43537 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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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.