MEDICARE: NEW LIFE HOME CARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568885606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE HOME CARE, LLC

Provider Business Mailing Address
First Line	:	1415 E DUBLIN GRANVILLE RD
Second Line	:	SUITE 207
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3356
Country	:	US
Telephone Number	:	614-896-6509
Fax Number	:	614-896-6510

Provider Business Practice Location Address
First Line	:	1415 E DUBLIN GRANVILLE RD STE 207
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3311
Country	:	US
Telephone Number	:	614-896-6509
Fax Number	:	614-896-6510

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	GODWIN K OWUSU
Credential	:
Telephone Number	:	614-896-6509

Provider Enumeration Date	:	01/25/2014
Last Update Date	:	03/29/2023

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