Organization
WHITE LIGHT BEHAVIORAL HEATH COLUMBUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE BOUDREAU (CHIEF OF STAFF)
(617) 839-0925
Entity
Organization
Contact information
Practice address
4040 E BROAD ST, COLUMBUS, OH 43213-1156
(615) 775-1931
Mailing address
4040 E BROAD ST, COLUMBUS, OH 43213-1156
(614) 350-4010
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/06/2022
Last updated
08/30/2023
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