MEDICARE: WAYA GROUP 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
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1205650280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYA GROUP HOME LLC

Provider Business Mailing Address
First Line	:	3175 CLEVELAND AVE UNIT 5
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3606
Country	:	US
Telephone Number	:	614-256-2797
Fax Number	:

Provider Business Practice Location Address
First Line	:	3105 WESTERVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3839
Country	:	US
Telephone Number	:	614-256-2797
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAHAD I HASSAN
Credential	:
Telephone Number	:	614-256-2797

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	11/14/2024

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Directions to “WAYA GROUP HOME LLC ” Practice Location

Language	Start Address	Practice Location

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