MEDICARE: PREMIER ADULT DAY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1851270169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER ADULT DAY CENTER LLC

Provider Business Mailing Address
First Line	:	1472 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6424
Country	:	US
Telephone Number	:	614-639-8937
Fax Number	:	614-639-8938

Provider Business Practice Location Address
First Line	:	1472 MORSE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6424
Country	:	US
Telephone Number	:	614-639-8937
Fax Number	:	614-639-8938

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FADUMO JAMA
Credential	:
Telephone Number	:	614-639-8937

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	08/29/2025

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