Healthcare Provider Details

I. General information

NPI: 1932846474
Provider Name (Legal Business Name): MARIA2 PROMISE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 04/07/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 BLATT BLVD
COLUMBUS OH
43230-6679
US

IV. Provider business mailing address

5661 EMPORIUM SQ
COLUMBUS OH
43231-2800
US

V. Phone/Fax

Practice location:
  • Phone: 614-632-1948
  • Fax:
Mailing address:
  • Phone: 614-632-1948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MARIATOU TRAWALLY KAIRA
Title or Position: OWNER
Credential:
Phone: 614-632-1948