Provider Demographics
NPI:1871863423
Name:COLUMBUS HOSPITAL, LLC
Entity Type:Organization
Organization Name:COLUMBUS HOSPITAL, LLC
Other - Org Name:COLUMBUS BEHAVIORIAL CENTER FOR CHILDREN AND ADOLESCENTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RECKELHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-562-5213
Mailing Address - Street 1:2223 POSHARD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-1844
Mailing Address - Country:US
Mailing Address - Phone:800-562-5213
Mailing Address - Fax:
Practice Address - Street 1:2223 POSHARD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-1844
Practice Address - Country:US
Practice Address - Phone:800-562-5213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN56765519873858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty