Healthcare Provider Details

I. General information

NPI: 1578385167
Provider Name (Legal Business Name): CARE CRUISE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4177 BEECHWOLD DR
COLUMBUS OH
43224-1823
US

IV. Provider business mailing address

4177 BEECHWOLD DR
COLUMBUS OH
43224-1823
US

V. Phone/Fax

Practice location:
  • Phone: 614-377-0984
  • Fax:
Mailing address:
  • Phone: 614-377-0984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: JAWAHIR MOHAMED
Title or Position: CEO
Credential:
Phone: 614-377-0984