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General NPI Number Information
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NPI Number | 1649132903
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Entity Type | Organization
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Legal Business Name | MOHABA LEADERS
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 29260 LAKE SHORE BLVD
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City | WILLOWICK
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State | OH
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Zip | 44095-4661
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Country | US
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Telephone | 216-767-6066
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Fax |
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Provider Business Mailing Address
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Address Line | 7675 PINECREST LN
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City | SOLON
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State | OH
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Zip | 44139-5362
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Country | US
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Telephone | 216-767-6066
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KARON JONES
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Credential |
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Telephone | 216-767-6066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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