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General NPI Number Information
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NPI Number | 1063710929
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Entity Type | Organization
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Legal Business Name | CARITAS HOME HEALTH CARE AND SUPPORTED LIVING
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 4204 POSSUM RUN CT W
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City | COLUMBUS
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State | OH
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Zip | 43224-6820
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Country | US
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Telephone | 614-973-1621
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Fax |
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Provider Business Mailing Address
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Address Line | 4204 POSSUM ROUND CT
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City | COLUMBUS
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State | OH
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Zip | 43224-6820
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Country | US
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Telephone | 614-973-1621
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SEKOU BAYOH KPOTO
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Credential |
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Telephone | 614-973-1621
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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 | OH
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | OH
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