NPIMap

Organization Active NPI

Recovery Services of Northwest Ohio, Inc

  • Clinic/Center
  • Defiance, OH
National Provider Identifier
1720046451
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
1140,1975,1297,0989 Issued in OH
Legal business name
RECOVERY SERVICES OF NORTHWEST OHIO, INC
Practice address
511 Perry St
Defiance, OH 43512-2123
Phone
(419) 782-9920
Fax
(419) 784-2523
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Authorized official

Name
Ruth Peck
Title
Ceo
Phone
(419) 782-9920

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X 1140,1975,1297,0989, OH
Local Education Agency (LEA) 251300000X 10998,3069,6686
Case Management Agency 251B00000X 1140,1975,1297,0989 OH
Case Management Agency 251B00000X 3069,6686 OH
Clinic/Center 261Q00000X 1140,1975,1297,0989 OH Primary
Clinic/Center 261Q00000X 3069,6686 OH
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1140,1975,1297,0989 OH
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 3069,6686 OH
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1140,1975,1297,0989 OH
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 3069,6686 OH

Addresses

Primary practice location

511 Perry St
Defiance, OH 43512-2123

Mailing address

511 Perry St
Defiance, OH 43512-2123
Phone (419) 782-9920

Other identifiers 2

IdentifierTypeStateIssuer
2846906MedicaidOH
1140OtherOHMACSIS UPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160204001858 OH Part B Supplier - Clinic/Group Practice 7113221508 Receives reassigned benefits from 20 practitioners
Practice locations: Fayette, OH; Wauseon, OH; Napoleon, OH; Defiance, OH; Bryan, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2065114Recovery Services of Northwest Ohio511 Perry St, Defiance, OH 43512Certificate of waiverSep 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Five County Alcoholdrug Program Serenity Haven4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

118 E Clinton St
Napoleon, OH 43545
Phone (419) 599-7040

560 W Linfoot St
Wauseon, OH 43567
Phone (419) 337-1973

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/rsnwo/r4/

Practitioners & affiliated clinicians

Practitioners 50

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

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1720046451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 PERRY ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122123",
            "telephone_number": "419-782-9920",
            "fax_number": "419-784-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 PERRY ST",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435122123",
            "telephone_number": "419-782-9920",
            "fax_number": "419-784-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY SERVICES OF NORTHWEST OHIO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-782-9920"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "OH",
            "license": "1140,1975,1297,0989,",
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": "10998,3069,6686",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OH",
            "license": "1140,1975,1297,0989",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OH",
            "license": "3069,6686",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": "1140,1975,1297,0989",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": "3069,6686",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OH",
            "license": "1140,1975,1297,0989",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "OH",
            "license": "3069,6686",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OH",
            "license": "1140,1975,1297,0989",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OH",
            "license": "3069,6686",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846906",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MACSIS UPI",
            "identifier": "1140",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Defiance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.