Provider Demographics
NPI:1467067124
Name:FOREVER CARE LLC
Entity Type:Organization
Organization Name:FOREVER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:ZAN
Authorized Official - Last Name:NKRUMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-558-6555
Mailing Address - Street 1:PO BOX 297983
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-7983
Mailing Address - Country:US
Mailing Address - Phone:614-558-6555
Mailing Address - Fax:
Practice Address - Street 1:5240 NORTHTOWNE BLVD APT C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-4661
Practice Address - Country:US
Practice Address - Phone:614-558-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities