=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841534187
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABC HOME HEALTH CARE PLUS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/26/2012
-----------------------------------------------------
Last Update Date | 11/26/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2021 E DUBLIN GRANVILLE RD SUITE 251
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43229-3568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-772-5086
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2021 E DUBLIN GRANVILLE RD SUITE 251
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43229-3568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ABDIRISAK YUSUF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-772-5086
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------