Healthcare Provider Details

I. General information

NPI: 1801570221
Provider Name (Legal Business Name): EMBASSY FOREST HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 E DUBLIN GRANVILLE RD
COLUMBUS OH
43231-4037
US

IV. Provider business mailing address

2841 E DUBLIN GRANVILLE RD
COLUMBUS OH
43231-4037
US

V. Phone/Fax

Practice location:
  • Phone: 614-891-1111
  • Fax: 614-794-6281
Mailing address:
  • Phone: 614-891-1111
  • Fax: 614-794-6281

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: NICHOLAS CICCONE
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 216-468-6322