Provider Demographics
NPI:1346864501
Name:BOAHEN HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:BOAHEN HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-322-5242
Mailing Address - Street 1:325 S SANDUSKY ST STE 204
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2680
Mailing Address - Country:US
Mailing Address - Phone:419-322-5242
Mailing Address - Fax:
Practice Address - Street 1:325 S SANDUSKY ST STE 204
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2680
Practice Address - Country:US
Practice Address - Phone:419-322-5242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3777HHNOtherOHIO DEPARTMENT OF HEALTH
OH0459501Medicaid