Provider Demographics
NPI:1629356126
Name:PASSION HEALTCARE SERVICES LLC
Entity Type:Organization
Organization Name:PASSION HEALTCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AJARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RNBSN
Authorized Official - Phone:614-327-6745
Mailing Address - Street 1:5187 NORTHCLIFF LOOP W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5251
Mailing Address - Country:US
Mailing Address - Phone:614-327-6745
Mailing Address - Fax:
Practice Address - Street 1:5187 NORTHCLIFF LOOP W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5251
Practice Address - Country:US
Practice Address - Phone:614-327-6745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health