Baymark Health Services of Ohio, Inc.
Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Elyria, OH
NPI 1669942934 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1669942934
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
- Legal business name
- BAYMARK HEALTH SERVICES OF OHIO, INC.
- Practice address
- 833 E Broad St Unit 1
Elyria, OH 44035-6557 - Phone
- (214) 379-3300
- NPI assigned
- Nov 29, 2018
- Organization subpart
- No
Authorized official
- Name
- Bruce Jarvie
- Title
- VP, Treasurer
- Phone
- (214) 379-3300
Other NPIs on the same Medicare enrollment 3
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2158686 | Baymark Health Services of Ohio, Inc | Certificate of waiver | Dec 3, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181003002472 | OH | Part B Supplier - Clinic/Group Practice | 3870845761 |
Receives reassigned benefits from 4 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Elyria, OH; Huber Heights, OH |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | Yes |
Addresses
Primary practice location
833 E Broad St Unit 1
Elyria, OH 44035-6557
Mailing address
1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300
Other names
- AppleGate Recovery Elyria
Other providers in Elyria, OH
- Nancy Ann Bartell
- Stefanie Marie Battisti
- Danielle Baumann
- Robert James Baumann
- Chloe Baxter
- Be Excellent Supports Together LLC
- Jennifer Beach
- Jacob Bechtel
- Eugene M Bedocs
- James J. Bedocs
All providers in Elyria, OH · Substance Use Disorder Rehabilitation Clinic/Center in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.