MEDICARE: TESFAI KIFLE

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

General Provider Information

NPI Number	:	1861351322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESFAI KIFLE

Provider Business Mailing Address
First Line	:	918 LOCKBOURNE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-1625
Country	:	US
Telephone Number	:	614-604-4260
Fax Number	:

Provider Business Practice Location Address
First Line	:	918 LOCKBOURNE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-1625
Country	:	US
Telephone Number	:	614-604-4260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ TESFAI KIFLE ” Practice Location

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