Provider Demographics
NPI:1407873359
Name:HARVEST HOME HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:HARVEST HOME HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEGOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-882-8902
Mailing Address - Street 1:2965 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4051
Mailing Address - Country:US
Mailing Address - Phone:614-882-8902
Mailing Address - Fax:
Practice Address - Street 1:2965 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4051
Practice Address - Country:US
Practice Address - Phone:614-882-8902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2542476314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368085Medicare ID - Type UnspecifiedHOME CARE SERVICES