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General NPI Number Information
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NPI Number | 1255124616
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Entity Type | Organization
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Legal Business Name | MENTEWABLLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1310 E ORANGE GROVE BLVD
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City | PASADENA
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State | CA
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Zip | 91104-3057
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Country | US
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Telephone | 323-999-2679
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Fax |
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Provider Business Mailing Address
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Address Line | 530 S LAKE AVE # 843
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City | PASADENA
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State | CA
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Zip | 91101-3515
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Country | US
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Telephone | 323-999-2679
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Fax |
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Authorized Official
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Title or Position | CARE DIRECTOR / MANAGING MEMBER
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Name | BERHANE GERMACHEW
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Credential |
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Telephone | 323-999-2679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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