MEDICARE: THE OHIO PARENTING CONNECTION, 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	251S00000X	Community/Behavioral Health Agency	1771699	OH

General Provider Information

NPI Number	:	1962641373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OHIO PARENTING CONNECTION, LLC

Provider Business Mailing Address
First Line	:	1364 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1042
Country	:	US
Telephone Number	:	614-445-0352
Fax Number	:

Provider Business Practice Location Address
First Line	:	1364 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1042
Country	:	US
Telephone Number	:	614-445-0352
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANNETTE J JOHNSON
Credential	:	L.I.S.W-S
Telephone Number	:	614-214-3658

Provider Enumeration Date	:	02/09/2009
Last Update Date	:	02/09/2009

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