Organization
EVERGREEN PATHWAYS HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAILA MOHAMED (CEO)
(614) 230-7005
Entity
Organization
Contact information
Practice address
3500 GROVE CITY RD, GROVE CITY, OH 43123-2598
(614) 230-7005
Mailing address
3500 GROVE CITY RD, GROVE CITY, OH 43123-2598
(614) 230-7005
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
01/04/2025
Last updated
04/28/2025
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