Provider Demographics
NPI:1396210894
Name:BOLINJI, CYRIL GEH (CEO)
Entity Type:Individual
Prefix:
First Name:CYRIL
Middle Name:GEH
Last Name:BOLINJI
Suffix:
Gender:M
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 WENDY WAY
Mailing Address - Street 2:
Mailing Address - City:W CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2620
Mailing Address - Country:US
Mailing Address - Phone:585-284-4979
Mailing Address - Fax:
Practice Address - Street 1:13 WENDY WAY
Practice Address - Street 2:
Practice Address - City:W CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:45449-2620
Practice Address - Country:US
Practice Address - Phone:585-284-4979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health