Provider Demographics
NPI:1972209443
Name:GAHANNA CARE LLC
Entity Type:Organization
Organization Name:GAHANNA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMININSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHUKRI
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:SAED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-927-7562
Mailing Address - Street 1:2567 SPARK ST
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-9321
Mailing Address - Country:US
Mailing Address - Phone:614-927-7562
Mailing Address - Fax:
Practice Address - Street 1:2567 SPARK ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-9321
Practice Address - Country:US
Practice Address - Phone:614-927-7562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care