Organization
PACE SUPPORTIVE LIVING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY DAWN OSEI (CEO)
(614) 373-6943
Entity
Organization
Contact information
Practice address
6886 LABURNUM DR, CANAL WINCHESTER, OH 43110-8596
(614) 862-0782
(614) 862-0783
Mailing address
6886 LABURNUM DR, CANAL WINCHESTER, OH 43110-8596
(614) 862-0782
(614) 862-0783
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075198
—
OH
01
—
2559995
DODD CONTRACT NUMBER
OH
Enumeration date
04/24/2012
Last updated
04/27/2016
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