Healthcare Provider Details

I. General information

NPI: 1063916948
Provider Name (Legal Business Name): ENABLING RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5945 SAWMILL RD STE B
DUBLIN OH
43017
US

IV. Provider business mailing address

5945 SAWMILL RD UNIT B
DUBLIN OH
43017-1623
US

V. Phone/Fax

Practice location:
  • Phone: 513-221-9982
  • Fax:
Mailing address:
  • Phone: 513-221-9982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. KEVIN DUANE JOHNSON
Title or Position: OWNER/CEO
Credential:
Phone: 513-221-9982