Healthcare Provider Details

I. General information

NPI: 1609749514
Provider Name (Legal Business Name): A SPARKLE OF ROSES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 CARBONE DR
COLUMBUS OH
43224-2014
US

IV. Provider business mailing address

1130 CARBONE DR
COLUMBUS OH
43224-2014
US

V. Phone/Fax

Practice location:
  • Phone: 614-867-6968
  • Fax:
Mailing address:
  • Phone: 614-867-6968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROL ANN TALLEY
Title or Position: ADMINISTRATIVE COMPLIANCE OFFICER
Credential:
Phone: 380-239-5252