Healthcare Provider Details

I. General information

NPI: 1518683226
Provider Name (Legal Business Name): ADA & CORINNE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 E LONG ST
COLUMBUS OH
43203-1990
US

IV. Provider business mailing address

1323 E LONG ST
COLUMBUS OH
43203-1990
US

V. Phone/Fax

Practice location:
  • Phone: 614-537-6466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SMITH
Title or Position: CEO/DIRECTOR
Credential:
Phone: 614-537-6466