Provider Demographics
NPI:1184053191
Name:MARY MUEMA
Entity type:Organization
Organization Name:MARY MUEMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT PERSONAL CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MUMBI
Authorized Official - Last Name:MUEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-314-7651
Mailing Address - Street 1:1912 RADNOR AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2217
Mailing Address - Country:US
Mailing Address - Phone:614-314-7651
Mailing Address - Fax:
Practice Address - Street 1:1912 RADNOR AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2217
Practice Address - Country:US
Practice Address - Phone:614-314-7651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child