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21 E State St Ste 200 Columbus OH 43215-0109 | |
| (614) 726-1485 | |
| (877) 564-4386 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 21 E State St Ste 200, Columbus, Ohio |
| Authorized Official Name and Position | Sabrina Betts (CEO) |
| Authorized Official Contact | 6787071415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
168 Carol Pl Douglasville GA 30134-7312 Ph: (704) 661-3327 | 21 E State St Ste 200 Columbus OH 43215-0109 Ph: (614) 726-1485 |
| NPI Number | 1669896130 |
|---|---|
| Provider Enumeration Date | 02/04/2014 |
| Last Update Date | 12/16/2024 |
| Certification Date | 12/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669896130 | NPI | - | NPPES |
| 0430058 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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