Healthcare Provider Details

I. General information

NPI: 1588347439
Provider Name (Legal Business Name): ESI MENSIMAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9730 W BLUEMOUND RD STE 4
MILWAUKEE WI
53226-4463
US

IV. Provider business mailing address

1433 N WATER ST FL 5
MILWAUKEE WI
53202-2557
US

V. Phone/Fax

Practice location:
  • Phone: 414-552-6997
  • Fax:
Mailing address:
  • Phone: 414-552-6997
  • 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: MR. KOJO GARBRAH
Title or Position: OPERATOR
Credential:
Phone: 414-552-6997