Healthcare Provider Details

I. General information

NPI: 1366252413
Provider Name (Legal Business Name): EMMANUEL HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CAMPUS VIEW BLVD STE 200
COLUMBUS OH
43235-4678
US

IV. Provider business mailing address

798 KENILWORTH LN
WESTERVILLE OH
43082-7550
US

V. Phone/Fax

Practice location:
  • Phone: 614-985-3600
  • Fax:
Mailing address:
  • Phone: 757-206-9321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TIMOTHY A CAFFEY
Title or Position: CEO/PRESIDENT
Credential:
Phone: 757-206-9321