Healthcare Provider Details
I. General information
NPI: 1225882418
Provider Name (Legal Business Name): TRANSITIONAL SUPPORT AND THERAPY CENTER BY KELKARES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/15/2024
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1409 E LIVINGSTON AVE
COLUMBUS OH
43205-2926
US
IV. Provider business mailing address
PO BOX 6051
COLUMBUS OH
43206-0051
US
V. Phone/Fax
- Phone: 614-747-7777
- Fax:
- Phone: 614-747-7777
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KELLY
S
JONES
Title or Position: FOUNDER
Credential: PEER SUPPORT
Phone: 614-747-7777