Provider Demographics
NPI:1174877781
Name:QUEST RECOVER & PREVENTION SERVICE
Entity type:Organization
Organization Name:QUEST RECOVER & PREVENTION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUDERMILT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-837-1883
Mailing Address - Street 1:1660 NAVE RD SE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-9604
Mailing Address - Country:US
Mailing Address - Phone:330-837-1883
Mailing Address - Fax:
Practice Address - Street 1:1660 NAVE RD SE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-9604
Practice Address - Country:US
Practice Address - Phone:330-837-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHW10000243245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children