Provider Demographics
NPI:1538872072
Name:NINA'S HEALTH CARE SERVICES
Entity type:Organization
Organization Name:NINA'S HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:FONGOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-314-5416
Mailing Address - Street 1:6455 E LIVINGSTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3589
Mailing Address - Country:US
Mailing Address - Phone:614-861-8840
Mailing Address - Fax:
Practice Address - Street 1:6455 E LIVINGSTON AVE STE A
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3589
Practice Address - Country:US
Practice Address - Phone:614-861-8840
Practice Address - Fax:614-861-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health