Provider Demographics
NPI:1598192320
Name:VIRGINIA KIMANI
Entity Type:Organization
Organization Name:VIRGINIA KIMANI
Other - Org Name:VIRGINIA KIMANI
Other - Org Type:Other Name
Authorized Official - Title/Position:CAREGIVER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:W
Authorized Official - Last Name:KIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-806-0164
Mailing Address - Street 1:8194 CHARLOTTE WAY AVE
Mailing Address - Street 2:8194 CHARLOTTE WAY AVE
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-7500
Mailing Address - Country:US
Mailing Address - Phone:614-806-0164
Mailing Address - Fax:
Practice Address - Street 1:8194 CHARLOTTE WAY AVE
Practice Address - Street 2:8194 CHAROTTE WAY AVE
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-7500
Practice Address - Country:US
Practice Address - Phone:614-806-0164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-13
Last Update Date:2013-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care