GEAUGA MEDICAL THERAPY CENTER LLC NPI 1376911495

NPI Information

NPI: 1376911495
Provider Name: GEAUGA MEDICAL THERAPY CENTER LLC
Classification: Family Medicine - 207QA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
13170 RAVENNA RD
SUITE 108
CHARDON, OH
ZIP 44024
Phone: (440) 409-7055
Get Directions

GEAUGA MEDICAL THERAPY CENTER LLC is an addiction medicine family medicine in Chardon, OH. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. GEAUGA MEDICAL THERAPY CENTER LLC NPI is 1376911495. The provider is registered as an organization entity type.

The provider's business location address is:

13170 RAVENNA RD
SUITE 108
CHARDON, OH
ZIP 44024-025
Phone: (440) 409-7055
Fax: (440) 279-4009

The provider's authorized official is Zaid Fadul .
The authorized official title is Ceo and has the following contact phone number (855) 360-4673.

The enumeration date for this NPI number is 9/5/2015 and was last updated on 7/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QC1500X	Clinic/Center	Community Health			No
2	261QP2300X	Clinic/Center	Primary Care	35.122879	OHIO	No
3	207QA0401X	Family Medicine	Addiction Medicine			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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