Healthcare Provider Details

I. General information

NPI: 1013611284
Provider Name (Legal Business Name): ADVOCATING CHOICES SUPPORT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 BULEN AVE
COLUMBUS OH
43205-2574
US

IV. Provider business mailing address

569 BULEN AVE
COLUMBUS OH
43205-2574
US

V. Phone/Fax

Practice location:
  • Phone: 380-223-4157
  • Fax:
Mailing address:
  • Phone: 380-223-4157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MS. TASHEA M GILES
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 380-223-4157