MEDICARE: MB HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1962137919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MB HOME CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 342
Second Line	:
City	:	NORTHFORD
State	:	CT
Zip	:	06472-0342
Country	:	US
Telephone Number	:	475-414-9018
Fax Number	:	203-842-3971

Provider Business Practice Location Address
First Line	:	6 EVA CT
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-3556
Country	:	US
Telephone Number	:	475-414-9018
Fax Number	:	203-842-3971

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN CELOTTO
Credential	:
Telephone Number	:	475-414-9018

Provider Enumeration Date	:	07/22/2022
Last Update Date	:	07/22/2022

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