MEDICARE: COLUMBUS HUMANITIES ARTS & TECHNOLOGY ACADEMY

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	251300000X	Local Education Agency (LEA)	000553	OH

General Provider Information

NPI Number	:	1679962336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS HUMANITIES ARTS & TECHNOLOGY ACADEMY

Provider Business Mailing Address
First Line	:	1333 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6322
Country	:	US
Telephone Number	:	614-261-1200
Fax Number	:	614-261-1201

Provider Business Practice Location Address
First Line	:	1333 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6322
Country	:	US
Telephone Number	:	614-261-1200
Fax Number	:	614-261-1201

Authorized Official
Title or Position	:	HEAD OF SCHOOL
Name	:	MISS LATASHA MORGAN
Credential	:
Telephone Number	:	614-261-1200

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	01/20/2015

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