Provider Demographics
NPI:1689144065
Name:VACMI EXTENDED FAMILY INC.
Entity Type:Organization
Organization Name:VACMI EXTENDED FAMILY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KOMLAN
Authorized Official - Middle Name:INNOCENT
Authorized Official - Last Name:SEGOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-375-3049
Mailing Address - Street 1:4770 INDIANOLA AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1862
Mailing Address - Country:US
Mailing Address - Phone:614-375-2057
Mailing Address - Fax:
Practice Address - Street 1:4770 INDIANOLA AVE STE 290
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1862
Practice Address - Country:US
Practice Address - Phone:614-375-2057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty