| Ridgeline Recovery Llc | |
|
491 Georgesville Rd Columbus OH 43228-2420 | |
| (614) 618-5000 | |
| Not Available |
| Full Name | Ridgeline Recovery Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 491 Georgesville Rd, Columbus, Ohio |
| Authorized Official Name and Position | Andy Danec (CEO) |
| Authorized Official Contact | 6142094046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgeline Recovery Llc 491 Georgesville Rd Columbus OH 43228-2420 Ph: (614) 618-5000 | Ridgeline Recovery Llc 491 Georgesville Rd Columbus OH 43228-2420 Ph: (614) 618-5000 |
| NPI Number | 1255099495 |
|---|---|
| Provider Enumeration Date | 12/06/2021 |
| Last Update Date | 10/18/2023 |
| Medicare PECOS PAC ID | 1658762034 |
|---|---|
| Medicare Enrollment ID | O20211217002197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255099495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
| Provider Name | Angel L Villanueva |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255370714 PECOS PAC ID: 4284620527 Enrollment ID: I20040422000855 |
| Provider Name | Shudonica Garlington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841434453 PECOS PAC ID: 1951666403 Enrollment ID: I20180604001317 |
| Provider Name | Moni A Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467758284 PECOS PAC ID: 7719346642 Enrollment ID: I20230710002339 |
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