=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548545775
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WE CARE HEALTHCARE AGENCY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2011
-----------------------------------------------------
Last Update Date | 11/02/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4449 EASTON WAY FL 2
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43219-7005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-934-1253
-----------------------------------------------------
Fax | 614-934-1624
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4449 EASTON WAY FL 2
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43219-7005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-934-1253
-----------------------------------------------------
Fax | 614-934-1624
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | LORI J LEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-934-1253
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 2012139
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------