Provider Demographics
NPI:1639240229
Name:CITY OF COLUMBUS
Entity Type:Organization
Organization Name:CITY OF COLUMBUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH COMMISSIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:614-645-7002
Mailing Address - Street 1:240 PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5331
Mailing Address - Country:US
Mailing Address - Phone:614-645-6070
Mailing Address - Fax:
Practice Address - Street 1:240 PARSONS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5331
Practice Address - Country:US
Practice Address - Phone:614-645-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01175OtherAOD OUTPATIENT TREATMENT