Individual provider · Type 1 NPI

Jacob Gordon

Child Intellectual and/or Developmental Disabilities Respite Care · Columbus, OH

NPI number 1619793015 Active

Practice location

1656 Canvasback Ln
Columbus, OH 43215-7023

Call (419) 270-6893 Map

Specialties and licenses

TaxonomyCodeLicense
Driver 172A00000XUR685742 (OH)
Private Vehicle 347C00000XUR685742 (OH)
Child Intellectual and/or Developmental Disabilities Respite Care Primary 385HR2060XNone listed

Child Intellectual and/or Developmental Disabilities Respite Care: A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.

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About NPI 1619793015

Jacob Gordon's National Provider Identifier is 1619793015, issued on Dec 2, 2024. The primary taxonomy on file is Child Intellectual and/or Developmental Disabilities Respite Care (385HR2060X), and the practice location is in Columbus, OH. The record was last updated on Dec 2, 2024.