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Organization
GOOD SAMARITAN SUPPORTED LIVING, LLC
Active
Organization
GOOD SAMARITAN SUPPORTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA THERESA YEBRA VILLANUEVA RN (RN MANAGER)
(614) 893-0579
Entity
Organization
Contact information
Practice address
616 MAWYER DR, COLUMBUS, OH 43085-5403
(614) 893-0579
Mailing address
616 MAWYER DR, COLUMBUS, OH 43085-5403
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
318641
OH
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
NULL
164W00000X
Licensed Practical Nurse
—
—
3747A0650X
Attendant Care Provider
Primary
—
NULL
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
NULL
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
NULL
374U00000X
Home Health Aide
—
—
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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