Healthcare Provider Details

I. General information

NPI: 1639086994
Provider Name (Legal Business Name): MBM BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 WINTERGREEN PL
ENGLEWOOD OH
45315-7721
US

IV. Provider business mailing address

503 WINTERGREEN PL
ENGLEWOOD OH
45315-7721
US

V. Phone/Fax

Practice location:
  • Phone: 937-360-8245
  • Fax:
Mailing address:
  • Phone: 937-360-8245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MERCY BATATIE OROCK
Title or Position: OWNER
Credential: PMHNP- BC
Phone: 937-360-8245