Healthcare Provider Details
I. General information
NPI: 1841731809
Provider Name (Legal Business Name): HOME REMEDY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2017
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 NORTHWOODS BLVD STE A
COLUMBUS OH
43235-7473
US
IV. Provider business mailing address
130 NORTHWOODS BLVD STE A
COLUMBUS OH
43235-7473
US
V. Phone/Fax
- Phone: 614-506-7825
- Fax: 614-388-5678
- Phone: 614-506-7825
- Fax: 614-388-5678
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
ERKIS
Title or Position: OWNER
Credential: PH.D
Phone: 614-596-5437