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General NPI Number Information
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NPI Number | 1801759964
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Entity Type | Organization
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Legal Business Name | FULL LIFE RECOVERY, LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 5959 SHARON WOODS BLVD
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City | COLUMBUS
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State | OH
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Zip | 43229-2644
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Country | US
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Telephone | 614-657-6351
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Fax |
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Provider Business Mailing Address
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Address Line | 5959 SHARON WOODS BLVD
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City | COLUMBUS
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State | OH
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Zip | 43229-2644
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Country | US
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Telephone | 614-657-6351
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | RICHARD G HALCOMBE JR.
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Credential | B.S., M.A, M.DIV, D.
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Telephone | 614-657-6351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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