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Organization
MIKE VACCA LLC
Active
Organization
MIKE VACCA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VACCA (OWNER)
(614) 364-6275
Entity
Organization
Contact information
Practice address
1500 W 3RD AVE, COLUMBUS, OH 43212-2843
(614) 364-6275
Mailing address
129 SHAWNEE DR, PICKERINGTON, OH 43147-8058
(614) 364-6275
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/05/2020
Last updated
10/05/2020
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