Healthcare Provider Details
I. General information
NPI: 1306632187
Provider Name (Legal Business Name): PROCARE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5900 ROCHE DR STE 201
COLUMBUS OH
43229-3290
US
IV. Provider business mailing address
5900 ROCHE DR STE 201
COLUMBUS OH
43229-3290
US
V. Phone/Fax
- Phone: 614-368-6285
- Fax: 614-468-1588
- Phone: 614-368-6285
- Fax: 614-468-1588
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FATOU
OUSMAN
CEESAY
Title or Position: ADMINISTRATOR
Credential: RN,BSN
Phone: 614-368-6285