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General NPI Number Information
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NPI Number | 1790475804
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Entity Type | Organization
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Legal Business Name | ONE COMMUNITY DEVELOPMENTAL SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 05/11/2023
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 1425 E DUBLIN GRANVILLE RD STE 105
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City | COLUMBUS
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State | OH
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Zip | 43229-3312
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Country | US
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Telephone | 614-906-4292
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Fax | 614-396-8841
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Provider Business Mailing Address
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Address Line | 325 WOODFIELD DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035-3536
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Country | US
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Telephone | 614-906-4292
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Fax | 614-396-8841
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Authorized Official
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Title or Position | OWNER
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Name | GODFRED OWUSU-SEKYERE
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Credential | CEO
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Telephone | 614-906-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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