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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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