Provider Demographics
NPI:1841034543
Name:690 COOPER ROAD OPS LLC
Entity type:Organization
Organization Name:690 COOPER ROAD OPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, CRED & CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-281-9050
Mailing Address - Street 1:133 HOLIDAY CT STE 102
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1386
Mailing Address - Country:US
Mailing Address - Phone:615-281-9050
Mailing Address - Fax:
Practice Address - Street 1:690 COOPER RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8900
Practice Address - Country:US
Practice Address - Phone:614-618-9834
Practice Address - Fax:866-422-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility