Provider Demographics
NPI:1972029890
Name:LEE-MITCHELL, PATRICK MAURICE SR
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:MAURICE
Last Name:LEE-MITCHELL
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 MAYFAIR AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-5305
Mailing Address - Country:US
Mailing Address - Phone:513-616-7924
Mailing Address - Fax:
Practice Address - Street 1:3403 MAYFAIR AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211
Practice Address - Country:US
Practice Address - Phone:513-616-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility