Healthcare Provider Details

I. General information

NPI: 1548827751
Provider Name (Legal Business Name): PYRAMID HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 MCNAUGHTEN GROVE LN
COLUMBUS OH
43213-5106
US

IV. Provider business mailing address

6041 MCNAUGHTEN GROVE LN
COLUMBUS OH
43213-5106
US

V. Phone/Fax

Practice location:
  • Phone: 614-584-1625
  • Fax: 614-367-6430
Mailing address:
  • Phone: 614-584-1625
  • Fax: 614-367-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: VICETA KING-RICHARDSON
Title or Position: PRESIDENT/CEO
Credential:
Phone: 614-584-1625