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NPI Code Detail

MEDICARE: REDEFINED LLC

MEDICARE: REDEFINED 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
1251S00000XCommunity/Behavioral Health Agency
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1750902250
Entity Type Code : Organization
Provider Name (Legal Business Name) : REDEFINED LLC
Provider Business Mailing Address
First Line : PO BOX 182
Second Line :
City : PICKERINGTON
State : OH
Zip : 43147-0182
Country : US
Telephone Number : 614-655-4300
Fax Number : 614-695-5300
Provider Business Practice Location Address
First Line : 1561 OLD LEONARD AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-2580
Country : US
Telephone Number : 614-655-4300
Fax Number : 614-695-5300
Authorized Official
Title or Position : PRESIDENT
Name : DR. JESSE SANDERS
Credential : PHD
Telephone Number : 614-655-4300
Provider Enumeration Date : 05/06/2020
Last Update Date : 08/07/2025

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Directions to “REDEFINED LLC ” Practice Location

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