Provider Demographics
NPI:1790376580
Name:CENTRAL COLUMBUS OH CAREGIVING LLC
Entity Type:Organization
Organization Name:CENTRAL COLUMBUS OH CAREGIVING LLC
Other - Org Name:CORNERSTONE CAREGIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-991-7836
Mailing Address - Street 1:209 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7415
Mailing Address - Country:US
Mailing Address - Phone:817-991-7836
Mailing Address - Fax:
Practice Address - Street 1:5544 HILLIARD ROME OFFICE PARK
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7286
Practice Address - Country:US
Practice Address - Phone:614-881-1090
Practice Address - Fax:614-881-1090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE CAREGIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-03
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care