Provider Demographics
NPI:1417642323
Name:AMBASSADOR HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:AMBASSADOR HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVI
Authorized Official - Middle Name:C
Authorized Official - Last Name:DHITAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-598-2192
Mailing Address - Street 1:9400 TOLLGATE RD SW
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-9443
Mailing Address - Country:US
Mailing Address - Phone:614-715-1478
Mailing Address - Fax:
Practice Address - Street 1:9400 TOLLGATE RD SW
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43062-9443
Practice Address - Country:US
Practice Address - Phone:614-715-1478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities