Healthcare Provider Details

I. General information

NPI: 1295063063
Provider Name (Legal Business Name): HOME CARE VILLAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2009
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 MORSE RD STE 108
COLUMBUS OH
43229-6434
US

IV. Provider business mailing address

1495 MORSE RD STE 108
COLUMBUS OH
43229-6434
US

V. Phone/Fax

Practice location:
  • Phone: 614-441-8851
  • Fax: 614-364-4025
Mailing address:
  • Phone: 614-441-8851
  • Fax: 614-364-4025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number200933600808
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: OMAR QALINLE
Title or Position: ADMINISTRATOR
Credential:
Phone: 952-688-3268