Provider Demographics
NPI:1124374525
Name:CENTENIAL HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:CENTENIAL HOME HEALTH CARE, LLC
Other - Org Name:CENTENIAL HOME CARE,LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LIBAN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:BULE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:614-397-1150
Mailing Address - Street 1:5767 VIENNA DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-4060
Mailing Address - Country:US
Mailing Address - Phone:614-397-1150
Mailing Address - Fax:
Practice Address - Street 1:5767 VIENNA DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-4060
Practice Address - Country:US
Practice Address - Phone:614-397-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health