Organization
ELVIS MBAH
Active
Other names
independent provider
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELVIS N MBAH STNA (HOMECARE)
(513) 693-3593
Entity
Organization
Contact information
Practice address
3265 ROCKER DR APT 4, CINCINNATI, OH 45239-4154
(513) 693-3593
Mailing address
3265 ROCKER DR APT 4, CINCINNATI, OH 45239-4154
(513) 693-3593
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121325
—
OH
Enumeration date
11/02/2015
Last updated
11/02/2015
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