Provider Demographics
NPI:1447956677
Name:PRIMROSE COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:PRIMROSE COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:SIKI
Authorized Official - Last Name:OWOLABANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-397-6407
Mailing Address - Street 1:779 FICUS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4862
Mailing Address - Country:US
Mailing Address - Phone:614-397-6407
Mailing Address - Fax:
Practice Address - Street 1:779 FICUS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43085-4862
Practice Address - Country:US
Practice Address - Phone:614-397-6407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care