Healthcare Provider Details

I. General information

NPI: 1508653213
Provider Name (Legal Business Name): HEALTH CONNECT AMERICA OF OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 BRADENTON AVE STE C
DUBLIN OH
43017-7582
US

IV. Provider business mailing address

PO BOX 682427
FRANKLIN TN
37068-2427
US

V. Phone/Fax

Practice location:
  • Phone: 614-943-4212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PRESTON MARTIN
Title or Position: EXECUTIVE OFFICER OF OPERATIONS
Credential:
Phone: 919-790-8580