Provider Demographics
NPI:1669161709
Name:MESH CARE SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:MESH CARE SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAWRATU
Authorized Official - Middle Name:BAH
Authorized Official - Last Name:JALLOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-377-3491
Mailing Address - Street 1:2929 WAMBLI DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3283
Mailing Address - Country:US
Mailing Address - Phone:301-377-3491
Mailing Address - Fax:
Practice Address - Street 1:2929 WAMBLI DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3283
Practice Address - Country:US
Practice Address - Phone:301-377-3491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health