Healthcare Provider Details

I. General information

NPI: 1730230343
Provider Name (Legal Business Name): COMMUNITY FOR NEW DIRECTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 E LIVINGSTON AVE
COLUMBUS OH
43227-2302
US

IV. Provider business mailing address

993 E MAIN ST
COLUMBUS OH
43205-2342
US

V. Phone/Fax

Practice location:
  • Phone: 614-252-4941
  • Fax: 855-908-2509
Mailing address:
  • Phone: 614-272-1464
  • Fax: 855-908-2509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number251B00000X
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number13316
License Number StateOH

VIII. Authorized Official

Name: MR. GREGORY A JEFFERSON
Title or Position: INTERIM EXECUTIVE DIRECTOR
Credential: OCPS II LICDC
Phone: 614-272-1464