Provider Demographics
NPI:1588738587
Name:ESI HOMECARE INC.
Entity type:Organization
Organization Name:ESI HOMECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAWERU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-899-7370
Mailing Address - Street 1:5467 AINSLEY DR.
Mailing Address - Street 2:SUITE 2027
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9598
Mailing Address - Country:US
Mailing Address - Phone:614-899-7370
Mailing Address - Fax:614-899-7370
Practice Address - Street 1:5467 AINSLEY DR
Practice Address - Street 2:SUITE 2027
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9598
Practice Address - Country:US
Practice Address - Phone:614-899-7370
Practice Address - Fax:614-899-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519439Medicaid