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Organization

LOWER LIGHTS CHRISTIAN HEALTH CENTER INC.

Active
Other names
CRIS
Organization subpart
No

Provider details

NPI number
Authorized official
TRACY CLOUD (CEO)
(614) 274-1455
Entity
Organization

Contact information

Practice address
4645 EXECUTIVE DR, COLUMBUS, OH 43220-3601
(614) 274-1455
(614) 274-1433
Mailing address
1160 W BROAD ST, COLUMBUS, OH 43222-1352
(614) 274-1455
(614) 274-1433

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
104100000X
Social Worker
207Q00000X
Family Medicine Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
363LP2300X
Primary Care Nurse Practitioner

Other

Enumeration date
11/03/2023
Last updated
11/03/2023
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