Provider Demographics
NPI:1568772721
Name:ZANESVILLE HOMECARE VENTURES, LLC
Entity Type:Organization
Organization Name:ZANESVILLE HOMECARE VENTURES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP LEGAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOPSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-299-1111
Mailing Address - Street 1:1050 FORRER BLVD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1472
Mailing Address - Country:US
Mailing Address - Phone:937-299-1111
Mailing Address - Fax:
Practice Address - Street 1:2503 MAPLE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1833
Practice Address - Country:US
Practice Address - Phone:740-452-5458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3139884Medicaid
36-7114Medicare PIN