Organization
GAHANNA HOME HEALTHCARE AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMILA A. IDRIS CNA (BUSINESS MANAGER)
(732) 877-9776
Entity
Organization
Contact information
Practice address
7451 BUNKER RIDGE CT, BLACKLICK, OH 43004
(732) 766-9112
Mailing address
7451 BUNKER RIDGE CT, BLACKLICK, OH 43004
(732) 766-9112
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
NA0008184328
NJ
347C00000X
Private Vehicle
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
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