NPIMap

Organization Active NPI

Mode - Miracles Occur Days Enriched a Non-Profit Corporation

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fairlawn, OH
National Provider Identifier
1083232102
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION
Practice address
50 Baker Blvd Ste 5a
Fairlawn, OH 44333-3603
Phone
(330) 388-5757
NPI assigned
Jul 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lisa Lenora Petrarca-Gamido, LICDC, SWANPI 1861923807
Title
Executive Director
Phone
(330) 388-5757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

50 Baker Blvd Ste 5a
Fairlawn, OH 44333-3603

Mailing address

50 Baker Blvd Ste 5a
Fairlawn, OH 44333-3603
Phone (330) 388-5757

Other names 1

  • The MODE- Miracles Occur Days Enriched A Non-Profit Corporation Other name

National Provider Directory

National Provider Directory

Locations

50 Baker Blvd
Ste 5A
Fairlawn, OH 44333
Phone (216) 772-3188

4301 Darrow Rd
Ste 2300
Stow, OH 44224
Phone (330) 388-5757

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1083232102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BAKER BLVD STE 5A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333603",
            "telephone_number": "330-388-5757",
            "fax_number": "330-294-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BAKER BLVD STE 5A",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333603",
            "telephone_number": "330-388-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "PETRARCA-GAMIDO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LENORA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-388-5757",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICDC, SWA"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The MODE- Miracles Occur Days Enriched A Non-Profit Corporation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The MODE- Miracles Occur Days Enriched A Non-Profit Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.