=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801469275
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OHIO HOME CARE CHOICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2021
-----------------------------------------------------
Last Update Date | 07/22/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 431 E HASKELL ST
-----------------------------------------------------
City | LOUDONVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44842-1312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-651-7324
-----------------------------------------------------
Fax | 614-737-5746
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 431 E HASKELL ST
-----------------------------------------------------
City | LOUDONVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44842-1312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-651-7324
-----------------------------------------------------
Fax | 614-737-5746
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SAMIYA ADAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 419-651-7324
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------