NPIMap

Organization Active NPI

Homeland Addiction Treatment Center LLC

Doing business as Homeland Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbus, OH
National Provider Identifier
1356020515
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HOMELAND ADDICTION TREATMENT CENTER LLC
Doing business as
Homeland Clinic
Practice address
3505 E Livingston Ave Ste G
Columbus, OH 43227-2252
Phone
(614) 632-1018
NPI assigned
Jul 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Authorized official

Name
Kingsley Eyong Enow, NPNPI 1477815892
Title
Supervisor
Phone
(614) 715-8316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

3505 E Livingston Ave Ste G
Columbus, OH 43227-2252

Mailing address

3505 E Livingston Ave Ste G
Columbus, OH 43227-2252
Phone (614) 715-8216

Other names 1

  • HOMELAND CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240404002235 OH Part B Supplier - Clinic/Group Practice 8426402736 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

National Provider Directory

National Provider Directory
Tax ID family
Homeland Addiction Treatment Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1356020515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 E LIVINGSTON AVE STE G",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272252",
            "telephone_number": "614-715-8216",
            "fax_number": "614-715-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 E LIVINGSTON AVE STE G",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432272252",
            "telephone_number": "614-632-1018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMELAND ADDICTION TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "ENOW",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_middle_name": "EYONG",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "614-715-8316",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOMELAND CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.