Provider Demographics
NPI:1104382407
Name:GORILLA VENTURES CORPORATION DBA RIGHT AT HOME OF CENTRAL OHIO
Entity Type:Organization
Organization Name:GORILLA VENTURES CORPORATION DBA RIGHT AT HOME OF CENTRAL OHIO
Other - Org Name:RIGHT AT HOME OF CENTRAL OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JP
Authorized Official - Middle Name:
Authorized Official - Last Name:VALIULIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-734-1110
Mailing Address - Street 1:8828 COMMERCE LOOP DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2121
Mailing Address - Country:US
Mailing Address - Phone:614-737-1110
Mailing Address - Fax:614-392-2885
Practice Address - Street 1:8828 COMMERCE LOOP DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2121
Practice Address - Country:US
Practice Address - Phone:614-737-1110
Practice Address - Fax:614-392-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA