Healthcare Provider Details

I. General information

NPI: 1992885529
Provider Name (Legal Business Name): GOODWILL INDUSTRIES OF CENTRAL OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 EDGEHILL RD
COLUMBUS OH
43212-3123
US

IV. Provider business mailing address

1331 EDGEHILL RD
COLUMBUS OH
43212-3123
US

V. Phone/Fax

Practice location:
  • Phone: 614-294-5181
  • Fax: 614-294-6895
Mailing address:
  • Phone: 614-294-5181
  • Fax: 614-294-6895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. ANTHONY HARTLEY
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 614-294-5181