Provider Demographics
NPI:1982316600
Name:WESTSIDE SENIOR CENTER LLC
Entity Type:Organization
Organization Name:WESTSIDE SENIOR CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMININSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ABDULLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-477-9313
Mailing Address - Street 1:3699 GLACIAL LN
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-3739
Mailing Address - Country:US
Mailing Address - Phone:614-477-9313
Mailing Address - Fax:
Practice Address - Street 1:3699 GLACIAL LN
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3739
Practice Address - Country:US
Practice Address - Phone:614-477-9313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care