Organization
INDEPENDENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVIS MBUNYA (L.P.N)
(216) 313-0897
Entity
Organization
Contact information
Practice address
6406 BUSCH BLVD APT 461, COLUMBUS, OH 43229-1853
(216) 313-0897
Mailing address
6406 BUSCH BLVD APT 461, COLUMBUS, OH 43229-1853
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
PN.155289-M-IV
OH
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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