Organization
LOWER LIGHTS CHRISTIAN HEALTH CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY MAUREY (CREDENTIALING SPECIALIST)
(614) 274-1455
Entity
Organization
Contact information
Practice address
69 S TERRACE AVE, NEWARK, OH 43055
(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
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0477562
—
OH
Enumeration date
07/15/2021
Last updated
06/08/2023
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