Provider Demographics
NPI:1407196967
Name:CENTRAL OHIO SUPPORTIVE CARE SERVICES, LLC
Entity Type:Organization
Organization Name:CENTRAL OHIO SUPPORTIVE CARE SERVICES, LLC
Other - Org Name:COSCS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:JENISE
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-561-7062
Mailing Address - Street 1:8137 REYNOLDSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-9328
Mailing Address - Country:US
Mailing Address - Phone:614-561-7062
Mailing Address - Fax:614-414-0221
Practice Address - Street 1:921 ROBINWOOD AVE
Practice Address - Street 2:SUITE E
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-6706
Practice Address - Country:US
Practice Address - Phone:614-561-7062
Practice Address - Fax:614-414-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services