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General NPI Number Information
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NPI Number | 1477299683
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Entity Type | Organization
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Legal Business Name | HEALX OHIO LLC
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 935 N CASSADY AVE
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City | COLUMBUS
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State | OH
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Zip | 43219-2283
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Country | US
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Telephone | 516-727-1634
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Fax |
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Provider Business Mailing Address
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Address Line | 281 TRESSER BLVD
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City | STAMFORD
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State | CT
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Zip | 06901-3284
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED PERSON
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Name | SAMUEL GOLDNER
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Credential |
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Telephone | 516-727-1634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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