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General NPI Number Information
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NPI Number | 1295527026
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Entity Type | Organization
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Legal Business Name | JOHN REESE LEGACY POINT
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 1135 OLMSTEAD AVE
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City | COLUMBUS
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State | OH
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Zip | 43201-3026
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Country | US
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Telephone | 614-930-7263
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Fax |
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Provider Business Mailing Address
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Address Line | 1135 OLMSTEAD AVE
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City | COLUMBUS
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State | OH
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Zip | 43201-3026
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Country | US
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Telephone | 614-930-7263
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAYLESHA CORDELL
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Credential | DSP
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Telephone | 614-930-7263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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