Provider Demographics
NPI:1194260844
Name:CENTENNIAL HOME CARE, LLC
Entity type:Organization
Organization Name:CENTENNIAL HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-316-7995
Mailing Address - Street 1:465 WATERBURY CT STE D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5312
Mailing Address - Country:US
Mailing Address - Phone:614-316-7995
Mailing Address - Fax:
Practice Address - Street 1:465 WATERBURY CT STE D
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-5312
Practice Address - Country:US
Practice Address - Phone:614-316-7995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3969539251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health