Healthcare Provider Details

I. General information

NPI: 1689385528
Provider Name (Legal Business Name): HADIYA ADULT DAYCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 CLEVELAND AVE
COLUMBUS OH
43224-2409
US

IV. Provider business mailing address

PO BOX 361001
COLUMBUS OH
43236-1001
US

V. Phone/Fax

Practice location:
  • Phone: 614-735-8411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: AYAN MOHAMED
Title or Position: CEO
Credential:
Phone: 614-779-6663