Healthcare Provider Details

I. General information

NPI: 1679321723
Provider Name (Legal Business Name): MAAYAN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6096 E MAIN ST STE 202
COLUMBUS OH
43213-4302
US

IV. Provider business mailing address

6096 E MAIN ST STE 202
COLUMBUS OH
43213-4302
US

V. Phone/Fax

Practice location:
  • Phone: 614-929-1931
  • Fax:
Mailing address:
  • Phone: 614-929-1931
  • 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 Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. MOHAMED FOFANAH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 614-929-1931