MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION NPI 1083232102

NPI Information

  • NPI: 1083232102
  • Provider Name: MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Other Name: THE MODE- MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION
  • CLIA Number: 36D2186615
  • Address: 50 BAKER BLVD STE 5A
    FAIRLAWN, OH
    ZIP 44333
  • Phone: (330) 388-5757

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NPI Details

MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION is a rehabilitation and substance use disorder clinic center in Fairlawn, OH. MODE - MIRACLES OCCUR DAYS ENRICHED A NON-PROFIT CORPORATION NPI is 1083232102. The provider is registered as an organization entity type.
The provider Other Name Is The Mode- Miracles Occur Days Enriched A Non-profit Corporation.

The provider's business location address is:

50 BAKER BLVD STE 5A
FAIRLAWN, OH
ZIP 44333-603
Phone: (330) 388-5757

The provider's authorized official is Lisa Lenora Petrarca-gamido .
The authorized official title is Executive Director and has the following contact phone number (330) 388-5757.

The CLIA number assigned to this NPI record is 36D2186615 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2020 and was last updated on 11/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

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This page was last updated on: 3/30/2025

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