Provider Demographics
NPI:1902178130
Name:PERSONALIZED HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:PERSONALIZED HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSC,
Authorized Official - Phone:614-754-1176
Mailing Address - Street 1:4663 EXECUTIVE DR
Mailing Address - Street 2:STE# 1
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3627
Mailing Address - Country:US
Mailing Address - Phone:614-754-1176
Mailing Address - Fax:614-754-1288
Practice Address - Street 1:4663 EXECUTIVE DR
Practice Address - Street 2:STE# 1
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:614-745-1176
Practice Address - Fax:614-754-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health