Healthcare Provider Details

I. General information

NPI: 1801759964
Provider Name (Legal Business Name): FULL LIFE RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 SHARON WOODS BLVD
COLUMBUS OH
43229-2644
US

IV. Provider business mailing address

5959 SHARON WOODS BLVD
COLUMBUS OH
43229-2644
US

V. Phone/Fax

Practice location:
  • Phone: 614-657-6351
  • Fax:
Mailing address:
  • Phone: 614-657-6351
  • 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: RICHARD G HALCOMBE JR.
Title or Position: FOUNDER
Credential: B.S., M.A, M.DIV, D.
Phone: 614-657-6351