Healthcare Provider Details

I. General information

NPI: 1881524767
Provider Name (Legal Business Name): HEARTWISE HOME CARE OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N HIGH ST STE 200
COLUMBUS OH
43215-3497
US

IV. Provider business mailing address

6120 GRAND CENTRAL PKWY APT B201
FOREST HILLS NY
11375-1286
US

V. Phone/Fax

Practice location:
  • Phone: 929-500-9989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JACOB BASALILOV
Title or Position: OWNER
Credential:
Phone: 929-500-9989