Healthcare Provider Details

I. General information

NPI: 1477208254
Provider Name (Legal Business Name): JERUSALEM HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2022
Last Update Date: 02/19/2022
Certification Date: 02/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 GLEN ARBOR DR
TOLEDO OH
43614-3205
US

IV. Provider business mailing address

1930 GLEN ARBOR DR
TOLEDO OH
43614-3205
US

V. Phone/Fax

Practice location:
  • Phone: 419-410-7544
  • Fax:
Mailing address:
  • Phone: 419-410-7544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ARREY ABUNAW
Title or Position: CEO
Credential:
Phone: 419-410-7544