Healthcare Provider Details

I. General information

NPI: 1801317102
Provider Name (Legal Business Name): LUTHERAN SOCIAL SERVICES OF CENTRAL OHIO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N GRANT AVE
COLUMBUS OH
43215-2641
US

IV. Provider business mailing address

1105 SCHROCK RD STE 100
COLUMBUS OH
43229-1165
US

V. Phone/Fax

Practice location:
  • Phone: 614-224-6617
  • Fax:
Mailing address:
  • Phone: 614-224-0747
  • Fax: 855-208-4527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA HUDDLESTON
Title or Position: HEALTH CENTER EXECUTIVE DIRECTOR
Credential:
Phone: 614-224-6617