Genesis Recovery and Wellness of Ohio

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

GENESIS RECOVERY AND WELLNESS OF OHIO

Doing business as

Genesis Recovery & Wellness of Ohio, LLC

Practice address

18051 Jefferson Park Rd Ste 106
Middleburg Heights, OH 44130-3460

Phone

(330) 443-0389

NPI assigned

Nov 25, 2022

Last updated

Dec 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mitchell Ozeri

Title

Ceo

Phone

(516) 528-5115

Specialties & licenses 1

Addresses

Other names 1

• Genesis Recovery & Wellness of Ohio, LLC Doing business as

Tax ID family

Genesis Recovery and Wellness of Ohio2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Genesis Recovery and Wellness of Ohio

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Middleburg Heights, OH
  • NPI 1609595685
  NPD tax ID

Locations

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

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1114637691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18051 JEFFERSON PARK RD STE 106",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303460",
            "telephone_number": "330-443-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18051 JEFFERSON PARK RD STE 106",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303460",
            "telephone_number": "330-443-0389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3632 W Market St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443332494",
            "country_code": "US",
            "telephone_number": "234-602-2360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENESIS RECOVERY AND WELLNESS OF OHIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "OZERI",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-528-5115"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis Recovery & Wellness of Ohio, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Genesis Recovery & Wellness of Ohio, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Gallagher, PT, DPT
• Kathi Gant, LISW
• Serafin Cruz Garcia Jr., M.D.
• Barbara Denise Gatz, RPH
• Genesis Brain Health
• Genesis Recovery and Wellness of Ohio
• Amanda George, PT, DPT, OCS
• Martina Waguih Naguib Gerges
• Lawrence A Gervasi, MD
• Bartolomeo Giannattasio, MD

• Substance Use Disorder Rehabilitation Clinic/Center in Middleburg Heights, OH
• Providers in Middleburg Heights, OH by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.