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General NPI Number Information
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NPI Number | 1306081047
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Entity Type | Organization
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Legal Business Name | DIRECTCARE SUPPORT PROFESSIONALS OF OHIO, LLC
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 921 ROBINWOOD AVE SUITE E
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City | WHITEHALL
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State | OH
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Zip | 43213-6706
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Country | US
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Telephone | 614-231-0220
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Fax | 614-231-0221
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Provider Business Mailing Address
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Address Line | 921 ROBINWOOD AVE SUITE E
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City | WHITEHALL
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State | OH
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Zip | 43213-6706
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Country | US
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Telephone | 614-414-0220
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Fax | 614-231-0221
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | MS. CAROL ANN TALLEY
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Credential |
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Telephone | 614-231-0220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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