Organization
AGENTIC CLIENT SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURTIS MCLENDON (AGENCY CEO)
(419) 961-5104
Entity
Organization
Contact information
Practice address
6281 MARSH WREN DR, COLUMBUS, OH 43230-6533
(614) 907-6782
Mailing address
6281 MARSH WREN DR, COLUMBUS, OH 43230-6533
(614) 907-6782
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0444477
—
OH
01
—
2573689
OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES
OH
Enumeration date
06/30/2021
Last updated
06/30/2021
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