Healthcare Provider Details

I. General information

NPI: 1124955257
Provider Name (Legal Business Name): LILIANE MNJOVU BOSUNGA DOO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 NORTHLAND BLVD STE 105
CINCINNATI OH
45246-3629
US

IV. Provider business mailing address

5740 RUNNING FOX LN
MASON OH
45040-4695
US

V. Phone/Fax

Practice location:
  • Phone: 513-346-9037
  • Fax:
Mailing address:
  • Phone: 513-346-9037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: