Healthcare Provider Details

I. General information

NPI: 1093655359
Provider Name (Legal Business Name): BOBO HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14211 AKRON AVE APT 319
ROSEMOUNT MN
55068-5596
US

IV. Provider business mailing address

14211 AKRON AVE APT 319
ROSEMOUNT MN
55068-5596
US

V. Phone/Fax

Practice location:
  • Phone: 614-900-1156
  • Fax:
Mailing address:
  • Phone: 614-900-1156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: KELVIN TEZEH MBANWEI
Title or Position: ADMNISTRATOR
Credential:
Phone: 614-900-1156