Silver Maple Recovery, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

SILVER MAPLE RECOVERY, LLC

Practice address

2101 Silver Maple Way
Lorain, OH 44053-2380

Phone

(440) 830-3400

Fax

(440) 830-3416

NPI assigned

Nov 20, 2018

Organization subpart

No

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

Authorized official

Name

Sue E Wiedenmannott

Title

Medicare Coordinator

Phone

(440) 989-5238

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1124597182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 OBERLIN AVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440532853",
            "telephone_number": "440-989-5238",
            "fax_number": "440-989-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 SILVER MAPLE WAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440532380",
            "telephone_number": "440-830-3400",
            "fax_number": "440-830-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER MAPLE RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-20",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "WIEDENMANNOTT",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICARE COORDINATOR",
        "authorized_official_telephone_number": "440-989-5238"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Shoureas
• Susanna Lynn Shultz, COTA/L
• Alen Siljak, MD
• Myrdeomar Silva
• Silver Maple Recovery LLC
• Jessica L Simantiras, LISW-S
• Matthew George Simkovich
• Cynthia M Simo, PCC-S
• Erin Simonson, PC-CR
• Laani M Sims

• Substance Use Disorder Rehabilitation Clinic/Center in Lorain, OH
• Providers in Lorain, 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 Jun 27, 2023; 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.