Provider Demographics
NPI:1063710929
Name:CARITAS HOME HEALTH CARE AND SUPPORTED LIVING
Entity type:Organization
Organization Name:CARITAS HOME HEALTH CARE AND SUPPORTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEKOU
Authorized Official - Middle Name:BAYOH
Authorized Official - Last Name:KPOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-973-1621
Mailing Address - Street 1:4204 POSSUM ROUND CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-6820
Mailing Address - Country:US
Mailing Address - Phone:614-973-1621
Mailing Address - Fax:
Practice Address - Street 1:4204 POSSUM RUN CT W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-6820
Practice Address - Country:US
Practice Address - Phone:614-973-1621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health