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NPI Code Detail

MEDICARE: ALEXANDER RECOVERY CENTER LLC

MEDICARE: ALEXANDER RECOVERY CENTER 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
1207QA0401XAddiction Medicine (Family Medicine) Physician
2207R00000XInternal Medicine Physician
3207RA0401XAddiction Medicine (Internal Medicine) Physician
4208D00000XGeneral Practice Physician
5207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1356863203
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEXANDER RECOVERY CENTER LLC
Provider Business Mailing Address
First Line : 620 BEAR RUN LN
Second Line :
City : LEWIS CENTER
State : OH
Zip : 43035-8299
Country : US
Telephone Number : 614-706-5206
Fax Number :
Provider Business Practice Location Address
First Line : 5825 WESTBOURNE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43213
Country : US
Telephone Number : 844-735-2773
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MICHAEL ALEXANDER
Credential :
Telephone Number : 844-735-2773
Provider Enumeration Date : 07/12/2017
Last Update Date : 01/11/2019

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Directions to “ALEXANDER RECOVERY CENTER LLC ” Practice Location

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