Organization
MERC SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BLAZEK (CFO)
(614) 306-1509
Entity
Organization
Contact information
Practice address
2001 E BEAUMONT RD, COLUMBUS, OH 43224-2228
(614) 980-4807
Mailing address
PO BOX 2796, COLUMBUS, OH 43216-2796
(614) 306-1509
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
11/20/2020
Last updated
11/20/2020
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