Healthcare Provider Details

I. General information

NPI: 1609751049
Provider Name (Legal Business Name): DAYS OF OUR LIVES MENTAL HEALTH AND RESIDENTIAL HOUSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3331 EAST LIVINGSTON AVE
COLUMBUS OH
43227
US

IV. Provider business mailing address

3331 E LIVINGSTON AVE
COLUMBUS OH
43227-1923
US

V. Phone/Fax

Practice location:
  • Phone: 614-805-6175
  • Fax:
Mailing address:
  • Phone: 614-805-6175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY HICKS WATSON
Title or Position: MANAGING MEMBER
Credential:
Phone: 614-805-6175