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General NPI Number Information
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NPI Number | 1487003968
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Entity Type | Organization
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Legal Business Name | MBL HEALTHCARE SYSTEM, LLC
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 12034 CREEKHURST DR
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City | HOUSTON
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State | TX
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Zip | 77099-3227
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Country | US
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Telephone | 281-780-1181
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Fax | 832-672-6136
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Provider Business Mailing Address
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Address Line | 12034 CREEKHURST DR
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City | HOUSTON
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State | TX
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Zip | 77099-3227
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Country | US
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Telephone | 281-780-1181
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Fax | 832-672-6136
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LORIE PENAFLOR OHUONU
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Credential |
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Telephone | 281-780-1181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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