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NPI Code Detail

MEDICARE: ESSENTIAL LIVING HEALTHCARE SERVICES

MEDICARE: ESSENTIAL LIVING HEALTHCARE SERVICES
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
1251E00000XHome Health Agency2558487OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184971426
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESSENTIAL LIVING HEALTHCARE SERVICES
Provider Business Mailing Address
First Line : 2259 NEW VILLAGE RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4048
Country : US
Telephone Number : 614-843-2268
Fax Number :
Provider Business Practice Location Address
First Line : 2259 NEW VILLAGE RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4048
Country : US
Telephone Number : 614-843-2268
Fax Number :
Authorized Official
Title or Position : CEO/OWNER
Name : RONDIA GOLIGHTLY
Credential :
Telephone Number : 614-843-2268
Provider Enumeration Date : 08/06/2012
Last Update Date : 08/06/2012

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Directions to “ESSENTIAL LIVING HEALTHCARE SERVICES ” Practice Location

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