Healthcare Provider Details

I. General information

NPI: 1982185740
Provider Name (Legal Business Name): THE RESPITE CENTERS OF OHIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 BAIRSFORD DR
COLUMBUS OH
43232-3007
US

IV. Provider business mailing address

1814 BAIRSFORD DR
COLUMBUS OH
43232-3007
US

V. Phone/Fax

Practice location:
  • Phone: 855-707-7770
  • Fax: 614-367-6463
Mailing address:
  • Phone: 614-572-2803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN391386
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: RACHELLE MACK
Title or Position: DIRECTOR
Credential: REGISTER NURSE
Phone: 855-707-7770