Healthcare Provider Details

I. General information

NPI: 1346728607
Provider Name (Legal Business Name): MAVYN HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W GREEN MEADOWS DR STE 90
GREENFIELD IN
46140-3205
US

IV. Provider business mailing address

400 W GREEN MEADOWS DR STE 90
GREENFIELD IN
46140-3205
US

V. Phone/Fax

Practice location:
  • Phone: 816-547-9248
  • Fax:
Mailing address:
  • Phone: 816-547-9248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MOSHE ORLILNSKY
Title or Position: OWNER
Credential:
Phone: 314-588-7518