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General NPI Number Information
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NPI Number | 1629907050
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Entity Type | Organization
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Legal Business Name | SURVIVE TO THRIVE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 4770 INDIANOLA AVE STE 110
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City | COLUMBUS
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State | OH
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Zip | 43214-1862
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Country | US
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Telephone | 614-206-4321
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Fax |
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Provider Business Mailing Address
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Address Line | 4770 INDIANOLA AVE STE 110
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City | COLUMBUS
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State | OH
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Zip | 43214-1862
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Country | US
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Telephone | 614-206-4321
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ANGELETTA L FAIR
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Credential | CDCA, QMHS LL
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Telephone | 614-680-3828
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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