Provider Demographics
NPI:1366853426
Name:CELINA GROUP
Entity Type:Organization
Organization Name:CELINA GROUP
Other - Org Name:LIBERTY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAZEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUSHAQRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-262-8582
Mailing Address - Street 1:1840 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-2537
Mailing Address - Country:US
Mailing Address - Phone:937-262-8582
Mailing Address - Fax:937-262-8592
Practice Address - Street 1:1840 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-2537
Practice Address - Country:US
Practice Address - Phone:937-262-8582
Practice Address - Fax:937-262-8592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty