MEDICARE: DAYLESHA CORDELL

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	251B00000X	Case Management Agency
2	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1851189187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAYLESHA CORDELL

Provider Business Mailing Address
First Line	:	1135 OLMSTEAD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3026
Country	:	US
Telephone Number	:	614-930-7263
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 OLMSTEAD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3026
Country	:	US
Telephone Number	:	614-930-7263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2025
Last Update Date	:	05/19/2025

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Directions to “ DAYLESHA CORDELL ” Practice Location

Language	Start Address	Practice Location

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