Healthcare Provider Details

I. General information

NPI: 1205765435
Provider Name (Legal Business Name): AMAVI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 EASTON WAY STE 200
COLUMBUS OH
43219-7005
US

IV. Provider business mailing address

4449 EASTON WAY STE 200
COLUMBUS OH
43219-7005
US

V. Phone/Fax

Practice location:
  • Phone: 614-664-3630
  • Fax:
Mailing address:
  • Phone: 614-664-3630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MIKKA ABBINGTON
Title or Position: CEO
Credential:
Phone: 614-270-3540