MEDICARE: OHIO CONSUMER 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1639449341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO CONSUMER CARE LLC

Provider Business Mailing Address
First Line	:	4345 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-1577
Country	:	US
Telephone Number	:	614-284-1821
Fax Number	:

Provider Business Practice Location Address
First Line	:	4345 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-1577
Country	:	US
Telephone Number	:	614-284-1821
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. FARAH A BARRE
Credential	:	CEO
Telephone Number	:	614-284-1821

Provider Enumeration Date	:	01/11/2012
Last Update Date	:	01/11/2012

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