Healthcare Provider Details

I. General information

NPI: 1487570420
Provider Name (Legal Business Name): RIDGE PRESTIGE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6096 E MAIN ST
COLUMBUS OH
43213-4302
US

IV. Provider business mailing address

7878 NARROW LEAF DR
BLACKLICK OH
43004-6046
US

V. Phone/Fax

Practice location:
  • Phone: 614-632-9101
  • Fax:
Mailing address:
  • Phone: 614-632-9101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: VERONICA YEBOAH
Title or Position: PMHNP
Credential:
Phone: 614-632-9101