Fatherly Instruction for Rebuilding Men LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

FATHERLY INSTRUCTION FOR REBUILDING MEN LLC

Practice address

785 Brentnell Ave
Columbus, OH 43219-2571

Phone

(740) 963-2073

NPI assigned

Feb 28, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marlon GoolsbyNPI 1356827588

Title

Ceo

Phone

(740) 963-2073

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marlon Marshon Goolsby

  • Addiction (Substance Use Disorder) Counselor
  • Shelby, OH
  • NPI 1356827588
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1093572836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 BRENTNELL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192571",
            "telephone_number": "740-963-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 BRENTNELL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432192571",
            "telephone_number": "740-963-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FATHERLY INSTRUCTION FOR REBUILDING MEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "MARLON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-963-2073"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child Intellectual and/or Developmental Disabilities Respite Care in Columbus, OH
• Providers in Columbus, OH by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.