| New Life Recovery Clinic 2 | |
|
25201 Chagrin Blvd Ste 390 Beachwood OH 44122-5637 | |
| (216) 770-3130 | |
| (216) 770-3100 |
| Full Name | New Life Recovery Clinic 2 |
|---|---|
| Speciality | General Practice |
| Location | 25201 Chagrin Blvd Ste 390, Beachwood, Ohio |
| Authorized Official Name and Position | Akari Tichavakunda (OWNER) |
| Authorized Official Contact | 2167703130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Life Recovery Clinic 2 1414 S Green Rd Ste 107 South Euclid OH 44121-3936 Ph: (440) 627-2600 | New Life Recovery Clinic 2 25201 Chagrin Blvd Ste 390 Beachwood OH 44122-5637 Ph: (216) 770-3130 |
| NPI Number | 1528711801 |
|---|---|
| Provider Enumeration Date | 01/27/2022 |
| Last Update Date | 01/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528711801 | NPI | - | NPPES |
| 1366431850 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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