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Organization
ADVANCE DD CARE, LLC
Active
Organization
ADVANCE DD CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOSSIVI ROGER DJAGLI (CEO)
(614) 500-1224
Entity
Organization
Contact information
Practice address
545 METRO PL S STE 100, DUBLIN, OH 43017-5353
(614) 500-1224
(614) 364-7469
Mailing address
PO BOX 20141, COLUMBUS, OH 43220-0141
(614) 500-1224
(614) 364-7469
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2945880
—
OH
Enumeration date
12/08/2009
Last updated
11/17/2020
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