Midwest Recovery Center LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

MIDWEST RECOVERY CENTER LLC

Practice address

4747 Monroe St
Toledo, OH 43623-4307

Phone

(833) 654-1029

NPI assigned

Jul 3, 2017

Last updated

Mar 11, 2024By 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

Kim Brown

Title

Director of Compliance

Phone

(870) 243-7219

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Midwest Recovery Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Midwest Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1407326366
  NPD tax ID
• Midwest Recovery Center LLC

  dba Ohio Treatment Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1598242281
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keionna Moore

  • Licensed Practical Nurse
  • Warren, OH
  • NPI 1346982097
  NPD (past)
• Marcus Paris

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
  • NPI 1770315558
  NPD (past)
• Alexis Stoutamire

  • Licensed Practical Nurse
  • Austintown, OH
  • NPI 1235541632
  NPD (past)

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1255852992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 MILL RUN CIR STE 810",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175549",
            "telephone_number": "866-203-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 MONROE ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234307",
            "telephone_number": "833-654-1029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7540 New West Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43617",
            "country_code": "US",
            "telephone_number": "866-203-0308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6629 W Central Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436171098",
            "country_code": "US",
            "telephone_number": "833-641-0632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 W State St",
            "address_purpose": "LOCATION",
            "city": "North Baltimore",
            "state": "OH",
            "postal_code": "458721332",
            "country_code": "US",
            "telephone_number": "866-203-0308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "870-243-7219"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0309004",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0326341",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Eye Consultants Ohio, Inc (Midwest Eye Consultants Ohio #402)
• Midwest Institute Inc
• Midwest Medical Lab LLC
• Midwest Modern Imaging, LLC
• Midwest Physician Services PC (Physician Services of Michigan)
• Midwest Recovery Center LLC
• Midwest Recovery Center LLC (Ohio Treatment Center)
• Maria R Mielcarek, MA, LPCC
• Adam T Mierzwa, MD
• Aimee Guillory Miester, NP

• Substance Use Disorder Rehabilitation Clinic/Center in Toledo, OH
• Providers in Toledo, 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 Mar 11, 2024; 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.