Healthcare Provider Details

I. General information

NPI: 1710578505
Provider Name (Legal Business Name): BARKS AND REC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 02/03/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W 5TH AVE
COLUMBUS OH
43212-2636
US

IV. Provider business mailing address

1010 W 5TH AVE
COLUMBUS OH
43212-2636
US

V. Phone/Fax

Practice location:
  • Phone: 614-725-1475
  • Fax:
Mailing address:
  • Phone: 614-725-1475
  • 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 Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. LEANNA ROCHELEAU
Title or Position: OWNER
Credential:
Phone: 614-571-1778