MEDICARE: WALNUT CREEK SOBER LIVING AND RECOVERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1356761928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALNUT CREEK SOBER LIVING AND RECOVERY LLC

Provider Business Mailing Address
First Line	:	12410 TAYLOR RD
Second Line	:
City	:	PLAIN CITY
State	:	OH
Zip	:	43064-9365
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3821 WALNUT CREEK DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2530
Country	:	US
Telephone Number	:	740-604-0279
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SEAN MOORE
Credential	:
Telephone Number	:	740-604-0279

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	04/22/2014

Similar Medicare Providers

1275631467 — DR. TERESA L LOVINS MD
Practice Location Address:

2530 SANDCREST BLVD
COLUMBUS, IN
47203-3060

Practice Phone: 812-900-2883
Practice Fax:

1144316894 — DOROTHY EILEEN BENNETT LCSW
Practice Location Address:

2530 SANDCREST BLVD
COLUMBUS, IN
47203

Practice Phone: 812-372-3177
Practice Fax: 812-372-3692

1265503452 — LUCINDA ANN DAVID MSW
Practice Location Address:

2530 SANDCREST BLVD
COLUMBUS, IN
47203-3047

Practice Phone: 812-660-2080
Practice Fax: 812-372-3692

1316013881 — ASSOCIATION OF PERSONAL AND FAMILY COUNSELORS
Practice Location Address:

2530 SANDCREST BLVD
COLUMBUS, IN
47203-3047

Practice Phone: 812-372-3177
Practice Fax: 812-372-3692

1528136652 — MRS. KIMBERLEE SUE MOORER M.S.
Practice Location Address:

2530 SANDCREST BLVD
COLUMBUS, IN
47203-3047

Practice Phone: 812-372-3177
Practice Fax:

1538237714 — MRS. LORI A FOWLER MSW, LCSW, ACSW
Practice Location Address:

2530 SANDCREST BLVD
COLUMBUS, IN
47203-3047

Practice Phone: 812-372-3177
Practice Fax:

Directions to “WALNUT CREEK SOBER LIVING AND RECOVERY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.