Provider Demographics
NPI:1619133147
Name:EASTLAND HOMECARE SERVICES LLC
Entity Type:Organization
Organization Name:EASTLAND HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-354-5767
Mailing Address - Street 1:8920 CORAL CANYON CIR
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-9521
Mailing Address - Country:US
Mailing Address - Phone:614-354-5727
Mailing Address - Fax:614-367-0206
Practice Address - Street 1:8920 CORAL CANYON CIR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-9521
Practice Address - Country:US
Practice Address - Phone:614-354-5727
Practice Address - Fax:614-367-0206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health