Provider Demographics
NPI:1629784988
Name:AHAVA HOSPICE AND PALLIATIVE CARE OF OHIO LLC
Entity Type:Organization
Organization Name:AHAVA HOSPICE AND PALLIATIVE CARE OF OHIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BERNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUINNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-288-4029
Mailing Address - Street 1:777 E MAIN ST STE 211
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-5300
Mailing Address - Country:US
Mailing Address - Phone:317-288-4029
Mailing Address - Fax:
Practice Address - Street 1:777 E MAIN ST STE 211
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-5300
Practice Address - Country:US
Practice Address - Phone:317-288-4029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based