Provider Demographics
NPI:1851189187
Name:CORDELL, DAYLESHA
Entity type:Individual
Prefix:
First Name:DAYLESHA
Middle Name:
Last Name:CORDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DAYLESHA
Other - Middle Name:
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1135 OLMSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3026
Mailing Address - Country:US
Mailing Address - Phone:614-930-7263
Mailing Address - Fax:
Practice Address - Street 1:1135 OLMSTEAD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3026
Practice Address - Country:US
Practice Address - Phone:614-930-7263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251B00000XAgenciesCase Management
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities