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General NPI Number Information
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NPI Number | 1437699543
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Entity Type | Organization
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Legal Business Name | MANIFESTING EXCELLENCE LLC
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 6100 CHANNINGWAY BLVD SUITE 605
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City | COLUMBUS
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State | OH
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Zip | 43232-2910
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Country | US
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Telephone | 614-694-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 CHANNINGWAY BLVD SUITE 605
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City | COLUMBUS
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State | OH
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Zip | 43232-2910
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Country | US
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Telephone | 614-626-8464
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Fax | 614-626-8809
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | LISA ANN CRAWLEY-MCGHEE
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Credential | LICDC-CS
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Telephone | 614-626-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 964511
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 964511
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License Number State | OH
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