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1649733445

NPI Code Detail

MEDICARE: OHIO ADDICTION MANAGEMENT LLC

MEDICARE: OHIO ADDICTION MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
3	251S00000X	Community/Behavioral Health Agency
4	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1649733445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO ADDICTION MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	1730 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1862
Country	:	US
Telephone Number	:	520-524-6084
Fax Number	:

Provider Business Practice Location Address
First Line	:	1730 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1862
Country	:	US
Telephone Number	:	520-524-6084
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ORLANDO CARTER
Credential	:
Telephone Number	:	731-935-9267

Provider Enumeration Date	:	04/09/2019
Last Update Date	:	04/26/2024

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Directions to “OHIO ADDICTION MANAGEMENT LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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