MEDICARE: MNTBLO HOME HEALTH INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1225910615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MNTBLO HOME HEALTH INC

Provider Business Mailing Address
First Line	:	104 W BEVERLY BLVD STE A-1
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4305
Country	:	US
Telephone Number	:	419-777-1777
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 W BEVERLY BLVD STE A-1
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-4305
Country	:	US
Telephone Number	:	419-777-1777
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANNA BONDARENKO
Credential	:
Telephone Number	:	419-777-1777

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	07/24/2025

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