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General NPI Number Information
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NPI Number | 1972996213
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Entity Type | Organization
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Legal Business Name | ADVANCED RECOVERY SUBSTANCE ABUSE SERVICES
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 326 S HIGH ST STE 200
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City | COLUMBUS
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State | OH
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Zip | 43215-4525
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Country | US
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Telephone | 614-353-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 326 S HIGH ST STE 200
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City | COLUMBUS
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State | OH
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Zip | 43215-4525
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Country | US
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Telephone | 614-353-4232
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | AALIYAH FAUNTLEROY
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Credential |
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Telephone | 614-353-4232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2193469
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License Number State | OH
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