Provider Demographics
NPI:1083676530
Name:PREVENTION COUNCIL OF CENTRAL OHIO
Entity Type:Organization
Organization Name:PREVENTION COUNCIL OF CENTRAL OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-220-8572
Mailing Address - Street 1:400 E MOUND ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5513
Mailing Address - Country:US
Mailing Address - Phone:614-220-8572
Mailing Address - Fax:614-220-8796
Practice Address - Street 1:400 E MOUND ST
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5513
Practice Address - Country:US
Practice Address - Phone:614-220-8572
Practice Address - Fax:614-220-8796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare