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General NPI Number Information
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NPI Number | 1730792524
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Entity Type | Organization
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Legal Business Name | FIVE POINTS RECOVERY LLC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 2575 W BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43204-3333
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Country | US
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Telephone | 614-809-6161
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | ETNA
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State | OH
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Zip | 43018-0130
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Country | US
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Telephone | 614-859-9733
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Fax | 615-591-3744
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Authorized Official
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Title or Position | CNP
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Name | LETISHA E LEACH
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Credential | APRN
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Telephone | 614-809-6161
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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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