Healthcare Provider Details

I. General information

NPI: 1003774928
Provider Name (Legal Business Name): A REDEFINING LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2242 S HAMILTON RD STE 208
COLUMBUS OH
43232-4300
US

IV. Provider business mailing address

520 HILL RD N UNIT 182
PICKERINGTON OH
43147-6508
US

V. Phone/Fax

Practice location:
  • Phone: 614-655-4300
  • Fax: 614-695-5300
Mailing address:
  • Phone: 614-655-4300
  • Fax: 614-695-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. DR JESSE SANDERS
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 614-655-4300