Provider Demographics
NPI:1770277154
Name:ALISA FARKAS LLC
Entity type:Organization
Organization Name:ALISA FARKAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-323-3230
Mailing Address - Street 1:2100 LYTHAM RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4632
Mailing Address - Country:US
Mailing Address - Phone:614-323-3230
Mailing Address - Fax:614-570-5772
Practice Address - Street 1:1500 W 3RD AVE STE 323
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2892
Practice Address - Country:US
Practice Address - Phone:614-323-3230
Practice Address - Fax:614-570-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)