Provider Demographics
NPI:1851713549
Name:CULPEPPER ENTERPRISES LLC
Entity Type:Organization
Organization Name:CULPEPPER ENTERPRISES LLC
Other - Org Name:CULPEPPER ENTERPRISES LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:BEDFORD
Authorized Official - Suffix:III
Authorized Official - Credentials:CRC LPC
Authorized Official - Phone:614-507-1472
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-0252
Mailing Address - Country:US
Mailing Address - Phone:614-507-1472
Mailing Address - Fax:
Practice Address - Street 1:9700 CROTTINGER RD
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-8888
Practice Address - Country:US
Practice Address - Phone:614-507-1472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC4622251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health