Healthcare Provider Details

I. General information

NPI: 1679403836
Provider Name (Legal Business Name): CHOSEN CONSCIOUS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 MITZI DR
COLUMBUS OH
43209-3263
US

IV. Provider business mailing address

2699 MITZI DR
COLUMBUS OH
43209-3263
US

V. Phone/Fax

Practice location:
  • Phone: 614-641-5511
  • Fax: 614-641-5511
Mailing address:
  • Phone: 614-641-5511
  • Fax: 614-641-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VENA THOMAS
Title or Position: OWNER
Credential:
Phone: 614-641-5511