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General NPI Number Information
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NPI Number | 1255099495
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Entity Type | Organization
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Legal Business Name | RIDGELINE RECOVERY LLC
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 491 GEORGESVILLE RD
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City | COLUMBUS
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State | OH
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Zip | 43228-2420
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Country | US
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Telephone | 614-618-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 491 GEORGESVILLE RD
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City | COLUMBUS
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State | OH
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Zip | 43228-2420
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Country | US
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Telephone | 614-618-5000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDY DANEC
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Credential |
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Telephone | 614-209-4046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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