Provider Demographics
NPI:1316600455
Name:M&O HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:M&O HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:O
Authorized Official - Last Name:EHIKHAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-525-8867
Mailing Address - Street 1:52 ALBERT ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-1801
Mailing Address - Country:US
Mailing Address - Phone:917-525-8867
Mailing Address - Fax:
Practice Address - Street 1:52 ALBERT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-1801
Practice Address - Country:US
Practice Address - Phone:917-525-8867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health