Provider Demographics
NPI:1730792524
Name:FIVE POINTS RECOVERY LLC
Entity type:Organization
Organization Name:FIVE POINTS RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:
Authorized Official - First Name:LETISHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:614-809-6161
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43018-0130
Mailing Address - Country:US
Mailing Address - Phone:614-859-9733
Mailing Address - Fax:615-591-3744
Practice Address - Street 1:2575 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3333
Practice Address - Country:US
Practice Address - Phone:614-809-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder