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Organization

DEPARTMENT OF VETERAN AFFAIRS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JUSTIN RICHARD BLACK LSW (SOCILA WORKER)
(614) 288-3103
Entity
Organization

Contact information

Practice address
420 N JAMES RD, COLUMBUS, OH 43219-1834
(614) 288-3103
Mailing address
420 N JAMES RD, COLUMBUS, OH 43219-1834
(614) 288-3103

Taxonomy

Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
S1600341
OH

Other

Enumeration date
06/22/2016
Last updated
06/22/2016
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