Provider Demographics
NPI:1801326962
Name:A1 X-CLUSIVE CARE
Entity type:Organization
Organization Name:A1 X-CLUSIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANEE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-733-8192
Mailing Address - Street 1:5546 LABRADOR LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-5898
Mailing Address - Country:US
Mailing Address - Phone:614-733-8192
Mailing Address - Fax:
Practice Address - Street 1:2105 S HAMILTON RD STE 202
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4145
Practice Address - Country:US
Practice Address - Phone:614-733-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health