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NPI Code Detail

MEDICARE: RIVER OF BLESSING HOME LLC

MEDICARE: RIVER OF BLESSING HOME LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320800000XMental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number : 1003682030
Entity Type Code : Organization
Provider Name (Legal Business Name) : RIVER OF BLESSING HOME LLC
Provider Business Mailing Address
First Line : 1838 ARLINGTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1812
Country : US
Telephone Number : 614-556-2857
Fax Number :
Provider Business Practice Location Address
First Line : 1838 ARLINGTON AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1812
Country : US
Telephone Number : 614-556-2857
Fax Number :
Authorized Official
Title or Position : OWNER/PROGRAM DIRECTOR
Name : NAJAH JAMA
Credential :
Telephone Number : 614-556-2857
Provider Enumeration Date : 11/30/2023
Last Update Date : 11/30/2023

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Directions to “RIVER OF BLESSING HOME LLC ” Practice Location

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