MEDICARE: DARYEL HEALTH CARE CENTER, 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		OH

General Provider Information

NPI Number	:	1598934424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARYEL HEALTH CARE CENTER, LLC.

Provider Business Mailing Address
First Line	:	1415 E DUBLIN GRANVILLE RD STE 107
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3311
Country	:	US
Telephone Number	:	614-825-0733
Fax Number	:	614-825-0734

Provider Business Practice Location Address
First Line	:	1415 E DUBLIN GRANVILLE RD STE 107
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3311
Country	:	US
Telephone Number	:	614-825-0733
Fax Number	:	614-825-0734

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. LIBAN ABDULLAHI ABDI
Credential	:
Telephone Number	:	614-825-0733

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	02/25/2008

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