Healthcare Provider Details

I. General information

NPI: 1205307402
Provider Name (Legal Business Name): BORN TO WIN CHRISTIAN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 MOCK RD
COLUMBUS OH
43219-1351
US

IV. Provider business mailing address

2501 MOCK RD
COLUMBUS OH
43219-1351
US

V. Phone/Fax

Practice location:
  • Phone: 614-478-2896
  • Fax: 614-478-2896
Mailing address:
  • Phone: 614-478-2896
  • Fax: 614-478-2896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN HARRELL
Title or Position: CENTER DIRECTOR
Credential:
Phone: 614-478-2896