Provider Demographics
NPI:1023303591
Name:FARADAH ADULT DAY CARE, LLC
Entity type:Organization
Organization Name:FARADAH ADULT DAY CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-218-6502
Mailing Address - Street 1:5834 COLUMBUS SQ
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-2811
Mailing Address - Country:US
Mailing Address - Phone:614-218-6502
Mailing Address - Fax:
Practice Address - Street 1:5798 COLUMBUS SQ
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2894
Practice Address - Country:US
Practice Address - Phone:614-218-6502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0184202Medicaid