Provider Demographics
NPI:1003060799
Name:COLUMBUS ADULT DAY CARE CENTER
Entity Type:Organization
Organization Name:COLUMBUS ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDULLAHI
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-392-2017
Mailing Address - Street 1:611 PARK MEADOW RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2875
Mailing Address - Country:US
Mailing Address - Phone:614-392-2017
Mailing Address - Fax:614-392-2103
Practice Address - Street 1:611 PARK MEADOW RD
Practice Address - Street 2:SUITE K
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2875
Practice Address - Country:US
Practice Address - Phone:614-392-2017
Practice Address - Fax:614-392-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-08
Last Update Date:2008-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2751268Medicaid