Healthcare Provider Details
I. General information
NPI: 1215682190
Provider Name (Legal Business Name): WESTGATE ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/18/2022
Last Update Date: 02/18/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3636 SOLDANO BLVD
COLUMBUS OH
43228-1422
US
IV. Provider business mailing address
3636 SOLDANO BLVD
COLUMBUS OH
43228-1422
US
V. Phone/Fax
- Phone: 614-966-1102
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABDI
JAMA
Title or Position: CEO
Credential:
Phone: 614-966-1102