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General NPI Number Information
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NPI Number | 1619816097
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Entity Type | Organization
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Legal Business Name | MBO DIVINE CARE LLC
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Dates
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Enumeration Date | 03/28/2026
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Last Update Date | 03/28/2026
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Provider Practice Location Address
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Address Line | 2831 PEARSE ST
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City | COLERAIN TOWNSHIP
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State | OH
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Zip | 45251-3511
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Country | US
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Telephone | 513-415-1016
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Fax | 513-415-1016
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Provider Business Mailing Address
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Address Line | 2831 PEARSE ST
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City | COLERAIN TOWNSHIP
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State | OH
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Zip | 45251-3511
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Country | US
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Telephone | 513-415-1016
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Fax | 513-415-1016
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Authorized Official
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Title or Position | CEO
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Name | MS. SANDRINE ANYI ACHU
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Credential | ACHU
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Telephone | 513-415-1016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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