Healthcare Provider Details

I. General information

NPI: 1780547984
Provider Name (Legal Business Name): NIMASUPPORT&CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5239 GOBEL DR
GROVEPORT OH
43125-9663
US

IV. Provider business mailing address

5239 GOBEL DR
GROVEPORT OH
43125-9663
US

V. Phone/Fax

Practice location:
  • Phone: 646-667-4348
  • Fax:
Mailing address:
  • Phone: 646-667-4348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: NIMATOULAYE DIALLO
Title or Position: COO
Credential:
Phone: 646-667-4348