Healthcare Provider Details

I. General information

NPI: 1447960588
Provider Name (Legal Business Name): TRUE NORTH INTERVENTION LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1783 E NORTH BROADWAY ST
COLUMBUS OH
43224-4365
US

IV. Provider business mailing address

1783 E NORTH BROADWAY ST
COLUMBUS OH
43224-4365
US

V. Phone/Fax

Practice location:
  • Phone: 614-704-6112
  • Fax:
Mailing address:
  • Phone: 614-704-6112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMARR HILL
Title or Position: CEO
Credential:
Phone: 614-704-6112