Healthcare Provider Details

I. General information

NPI: 1598569576
Provider Name (Legal Business Name): OHANA RESIDENTIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3938 DILLON DR
COLUMBUS OH
43227-1707
US

IV. Provider business mailing address

3938 DILLON DR
COLUMBUS OH
43227-1707
US

V. Phone/Fax

Practice location:
  • Phone: 614-421-8413
  • Fax:
Mailing address:
  • Phone: 614-421-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MIRANDA JONES
Title or Position: OWNER
Credential:
Phone: 614-421-8413