Provider Demographics
NPI:1033711098
Name:MEB LIFE HOME CARE LLC
Entity Type:Organization
Organization Name:MEB LIFE HOME CARE LLC
Other - Org Name:MEB LIFE HOME CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-614-8275
Mailing Address - Street 1:1238 2ND AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-5241
Mailing Address - Country:US
Mailing Address - Phone:334-614-8275
Mailing Address - Fax:
Practice Address - Street 1:1238 2ND AVE STE 6
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-5241
Practice Address - Country:US
Practice Address - Phone:334-614-8275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No347C00000XTransportation ServicesPrivate Vehicle