Healthcare Provider Details

I. General information

NPI: 1003947607
Provider Name (Legal Business Name): COMMUNITY INTERACTION OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 RADCLIFF DR 479 RADCLIFF DR,
WESTERVILLE OH
43082-6356
US

IV. Provider business mailing address

479 RADCLIFF DR 479 RADCLIFF DR
WESTERVILLE OH
43082-6356
US

V. Phone/Fax

Practice location:
  • Phone: 614-432-7266
  • Fax:
Mailing address:
  • Phone: 614-432-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1584764
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1024531420002
License Number StatePA

VIII. Authorized Official

Name: MR. FODAY L TURAY SR.
Title or Position: OWNER & DIRECTOR
Credential: STILL IN COLLEDGE
Phone: 614-432-7266