Provider Demographics
NPI:1710760954
Name:HUDA
Entity Type:Organization
Organization Name:HUDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:SABRIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-966-0390
Mailing Address - Street 1:5617 COUNTRIE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-9068
Mailing Address - Country:US
Mailing Address - Phone:614-966-0390
Mailing Address - Fax:
Practice Address - Street 1:5617 COUNTRIE GLEN DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-9068
Practice Address - Country:US
Practice Address - Phone:614-966-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty