MEDAVI TREATMENT LLC NPI 1174389597

NPI Information

  • NPI: 1174389597
  • Provider Name: MEDAVI TREATMENT LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 36D2305762
  • Address: 6629 W CENTRAL AVE STE A
    TOLEDO, OH
    ZIP 43617
  • Phone: (567) 268-4226

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NPI Details

MEDAVI TREATMENT LLC is a rehabilitation and substance use disorder clinic center in Toledo, OH. MEDAVI TREATMENT LLC NPI is 1174389597. The provider is registered as an organization entity type.

The provider's business location address is:

6629 W CENTRAL AVE STE A
TOLEDO, OH
ZIP 43617-098
Phone: (567) 268-4226
Fax: (567) 288-2087

The provider's authorized official is Kim Brown .
The authorized official title is Director Of Compliance and has the following contact phone number (870) 243-7219.

The CLIA number assigned to this NPI record is 36D2305762 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/23/2024 and was last updated on 3/11/2024.

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?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

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