Walnut Creek Sober Living and Recovery LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

WALNUT CREEK SOBER LIVING AND RECOVERY LLC

Practice address

3821 Walnut Creek Dr
Columbus, OH 43224-2530

Phone

(740) 604-0279

NPI assigned

Apr 22, 2014

Organization subpart

No

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

Authorized official

Name

Sean Moore

Title

Ceo

Phone

(740) 604-0279

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398124800000",
    "number": "1356761928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12410 TAYLOR RD",
            "city": "PLAIN CITY",
            "state": "OH",
            "postal_code": "430649365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 WALNUT CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432242530",
            "telephone_number": "740-604-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT CREEK SOBER LIVING AND RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-22",
        "last_updated": "2014-04-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-604-0279"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Walls
• Scott William Walls, PA-C
• Tamera Walls
• Tanasia Walls
• Victor Lamar Walls Jr.
• Amanda Walpole
• Bryant James Walrod, MD
• Brian Walsh, MD
• Elizabeth Walsh, CT
• Jewell Walsh, LPCC-S

• Clinical Medical Laboratory in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Medical Laboratory in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.