Organization
LARUE PSYCHIATRIC SERVICES LLC
Active
Other names
Keystone
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KHALILAH KRYSTAL LARUE C.N.P. (CERTFIED NURSE PRACTITIONER)
(614) 668-2149
Entity
Organization
Contact information
Practice address
4449 EASTON WAY STE 200, COLUMBUS, OH 43219-7005
(614) 208-4973
(888) 858-4293
Mailing address
4449 EASTON WAY STE 200, COLUMBUS, OH 43219-7005
(614) 208-4973
(888) 858-4293
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10483
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003260122B
—
GA
05
—
0076744
—
OH
Enumeration date
03/21/2017
Last updated
09/02/2025
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