# GAHANNA HOME HEALTHCARE AGENCY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134643471
- **Authorized official:** JAMILA A. IDRIS CNA (BUSINESS MANAGER)
- **Authorized official phone:** (732) 877-9776

## Contact information

- **Practice address:** 7451 BUNKER RIDGE CT, BLACKLICK, OH 43004
- **Practice address phone:** (732) 766-9112
- **Mailing address:** 7451 BUNKER RIDGE CT, BLACKLICK, OH 43004
- **Mailing address phone:** (732) 766-9112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | NA0008184328 | NJ | Yes |
| 347C00000X | Private Vehicle | — | NULL | — |
| 376K00000X | Nurse's Aide | — | NULL | — |
| 376K00000X | Nurse's Aide | — | — | — |

## Other

- **Enumeration date:** 07/28/2017
- **Last updated:** 07/28/2017