Provider Demographics
NPI:1962246413
Name:RAY RECOVERY OH LLC
Entity type:Organization
Organization Name:RAY RECOVERY OH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-355-9729
Mailing Address - Street 1:4403 15TH AVE STE 196
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-1604
Mailing Address - Country:US
Mailing Address - Phone:212-461-4729
Mailing Address - Fax:
Practice Address - Street 1:1737 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-5013
Practice Address - Country:US
Practice Address - Phone:330-355-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health