Active NPI
Lake-Geauga Recovery Centers, Inc.
- Substance Abuse Rehabilitation Facility
- Mentor, OH
National Provider Identifier
1750489779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- LAKE-GEAUGA RECOVERY CENTERS, INC.
- Practice address
- 9083 Mentor Avenue
Mentor, OH 44060-6348 - Phone
- (440) 205-2674
- Fax
- (440) 255-6348
- NPI assigned
- Sep 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Michelle Bertman, LISW-S
- Title
- President Ceo
- Phone
- (440) 205-2674
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
9083 Mentor Avenue
Mentor, OH 44060-6348
Mailing address
9083 Mentor Avenue
Mentor, OH 44060-6348
Phone (440) 205-2674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316 | Medicaid | OH |
Other names 1
- Lake Geauga Center on Alcoholism and Drug Abuse Inc
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160628001636 | OH | Part B Supplier - Clinic/Group Practice | 6406147198 |
Receives reassigned benefits from 12 practitioners Practice locations: Painesville, OH; Mentor, OH; Concord Township, OH; Chardon, OH |
National Provider Directory
National Provider Directory- Tax ID family
- Lake-Geauga Recovery Centers Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Mentor, OH
- NPI 1326305582
Locations
209 Center St
Unit E
Chardon, OH 44024
Phone (440) 285-8533
796 Oak St
Painesville, OH 44077
Phone (440) 205-2673
760 Oak St
Painesville, OH 44077
Phone 44025506782008
Practitioners & affiliated clinicians
Practitioners 23
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Addiction (Substance Use Disorder) Counselor
- Mentor, OH
- NPI 1225318892
OH
-
- Addiction (Substance Use Disorder) Counselor
- Mentor, OH
- NPI 1154872117
OH
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1786060800000",
"number": "1750489779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9083 MENTOR AVENUE",
"city": "MENTOR",
"state": "OH",
"postal_code": "440606348",
"telephone_number": "440-205-2674",
"fax_number": "440-255-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9083 MENTOR AVENUE",
"city": "MENTOR",
"state": "OH",
"postal_code": "440606348",
"telephone_number": "440-205-2674",
"fax_number": "440-255-6348"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAKE-GEAUGA RECOVERY CENTERS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-21",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A",
"authorized_official_last_name": "BERTMAN",
"authorized_official_first_name": "MICHELLE",
"authorized_official_title_or_position": "PRESIDENT CEO",
"authorized_official_telephone_number": "440-205-2674",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LISW-S"
},
"taxonomies": [
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1316",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lake Geauga Center on Alcoholism and Drug Abuse Inc",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Mentor, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.