Provider Demographics
NPI:1932960713
Name:ONPAK GROUP HOME LLC
Entity Type:Organization
Organization Name:ONPAK GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDAI-MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-403-0902
Mailing Address - Street 1:2025 WALTON AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2025 WALTON AVE APT 3D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4120
Practice Address - Country:US
Practice Address - Phone:646-403-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care