Healthcare Provider Details

I. General information

NPI: 1316850514
Provider Name (Legal Business Name): COLUMBUS PERFOMANCE HIGH SCHOOL EAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2745 WINCHESTER PIKE
COLUMBUS OH
43232
US

IV. Provider business mailing address

2745 WINCHESTER PIKE
COLUMBUS OH
43232
US

V. Phone/Fax

Practice location:
  • Phone: 614-612-0660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ABBIE BREWER
Title or Position: DEPUTY CHIEF OF STAFF
Credential:
Phone: 614-357-2789