Provider Demographics
| NPI: | 1699363937 |
|---|---|
| Name: | MBI HEALTH SERVICES LLC |
| Entity Type: | Organization |
| Organization Name: | MBI HEALTH SERVICES LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRINCIPAL |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KWABENA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | ANDOH |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 202-388-4300 |
| Mailing Address - Street 1: | 7200 WISCONSIN AVE STE 702 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BETHESDA |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 20814-4891 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 202-388-4300 |
| Mailing Address - Fax: | 202-379-3270 |
| Practice Address - Street 1: | 777 S ALAMEDA ST FL 2 |
| Practice Address - Street 2: | |
| Practice Address - City: | LOS ANGELES |
| Practice Address - State: | CA |
| Practice Address - Zip Code: | 90021-1657 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 202-388-4300 |
| Practice Address - Fax: | 202-379-3270 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2021-01-04 |
| Last Update Date: | 2021-01-04 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 251B00000X | Agencies | Case Management | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | Dental |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QM1000X | Ambulatory Health Care Facilities | Clinic/Center | Migrant Health |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
| No | 261QM2800X | Ambulatory Health Care Facilities | Clinic/Center | Methadone |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
