Provider Demographics
NPI:1891517710
Name:ELIZABETH ADULT DAYCARE CORPORATION
Entity type:Organization
Organization Name:ELIZABETH ADULT DAYCARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULINA
Authorized Official - Middle Name:I
Authorized Official - Last Name:IYERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-615-7894
Mailing Address - Street 1:1174 ROMONA PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-4328
Mailing Address - Country:US
Mailing Address - Phone:614-615-7894
Mailing Address - Fax:
Practice Address - Street 1:1174 ROMONA PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-4328
Practice Address - Country:US
Practice Address - Phone:614-615-7894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care