Healthcare Provider Details

I. General information

NPI: 1235055344
Provider Name (Legal Business Name): ELLIS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11912 SPRING CREEK DR
PICKERINGTON OH
43147-7972
US

IV. Provider business mailing address

1209 HILL RD N # 214
PICKERINGTON OH
43147-7008
US

V. Phone/Fax

Practice location:
  • Phone: 614-678-1205
  • Fax: 614-386-2081
Mailing address:
  • Phone: 614-678-1205
  • Fax: 614-386-2081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAMEELA THOMAS
Title or Position: OWNER
Credential:
Phone: 614-678-1205