Provider Demographics
NPI:1558942078
Name:FOUR WORLDS HEALTHCARE LLC
Entity type:Organization
Organization Name:FOUR WORLDS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISMENE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ABIDOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-208-9578
Mailing Address - Street 1:4010 EXECUTIVE PARK DR STE 136
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2099
Mailing Address - Country:US
Mailing Address - Phone:513-601-9388
Mailing Address - Fax:
Practice Address - Street 1:4010 EXECUTIVE PARK DR STE 136
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2099
Practice Address - Country:US
Practice Address - Phone:513-601-9388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-16
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0480587Medicaid