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General NPI Number Information
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NPI Number | 1003569427
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Entity Type | Organization
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Legal Business Name | EXCEPTIONAL1 HOME CARE, LLC
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 2896 TOWNSHIP ROAD 749
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City | LOUDONVILLE
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State | OH
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Zip | 44842-9518
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Country | US
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Telephone | 614-348-7805
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Fax | 800-568-9005
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Provider Business Mailing Address
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Address Line | 926 LOEW ST
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City | COLUMBUS
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State | OH
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Zip | 43201-3011
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Country | US
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Telephone | 614-348-7805
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMI LYNN CRIST
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Credential | RN
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Telephone | 614-348-7805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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