Healthcare Provider Details

I. General information

NPI: 1851282008
Provider Name (Legal Business Name): QUIET WATERS CLINICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9039 ANTARES AVE STE B1
COLUMBUS OH
43240-4067
US

IV. Provider business mailing address

9039 ANTARES AVE STE B1
COLUMBUS OH
43240-4067
US

V. Phone/Fax

Practice location:
  • Phone: 614-698-6413
  • Fax: 614-505-0077
Mailing address:
  • Phone: 614-698-6413
  • Fax: 614-505-0077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CRISTHIAN ALEJANDRO HAQUIN
Title or Position: OWNER / CEO
Credential: MD
Phone: 614-698-6413