Provider Demographics
NPI:1922410646
Name:PASSION PLUSS DODD LLC
Entity Type:Organization
Organization Name:PASSION PLUSS DODD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AJARA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-327-6745
Mailing Address - Street 1:5187 NORTHCLIFF LOOP W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5251
Mailing Address - Country:US
Mailing Address - Phone:614-327-6745
Mailing Address - Fax:
Practice Address - Street 1:5187 NORTHCLIFF LOOP W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5251
Practice Address - Country:US
Practice Address - Phone:614-327-6745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0102755Medicaid