Provider Demographics
NPI:1417223603
Name:GOODHEARTS CARE SERVICES LLC
Entity Type:Organization
Organization Name:GOODHEARTS CARE SERVICES LLC
Other - Org Name:GOODHEARTS CARE SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AWESKOSHIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KOSHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-615-2858
Mailing Address - Street 1:3350 CLEVELAND AVE # 1936
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3677
Mailing Address - Country:US
Mailing Address - Phone:614-615-2858
Mailing Address - Fax:
Practice Address - Street 1:3350 CLEVELAND AVE # 1936
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3677
Practice Address - Country:US
Practice Address - Phone:614-615-2858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-01
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care