Provider Demographics
NPI:1588178693
Name:HILLIARD HOME CARE, LLC
Entity Type:Organization
Organization Name:HILLIARD HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:ATEYAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-742-7777
Mailing Address - Street 1:5515 SCIOTO DARBY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-1325
Mailing Address - Country:US
Mailing Address - Phone:614-742-7777
Mailing Address - Fax:833-790-2139
Practice Address - Street 1:5515 SCIOTO DARBY RD STE 202
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1325
Practice Address - Country:US
Practice Address - Phone:614-742-7777
Practice Address - Fax:833-790-2139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-28
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0335394Medicaid