Provider Demographics
NPI:1174057004
Name:ADDICTION CAMPUSES OF OHIO LLC
Entity type:Organization
Organization Name:ADDICTION CAMPUSES OF OHIO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-921-4447
Mailing Address - Street 1:205 REIDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1618
Mailing Address - Country:US
Mailing Address - Phone:615-921-4447
Mailing Address - Fax:615-921-5918
Practice Address - Street 1:2650 LODGE RD SW
Practice Address - Street 2:
Practice Address - City:SHERRODSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44675-9718
Practice Address - Country:US
Practice Address - Phone:615-921-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OH201708802010324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty