Provider Demographics
NPI:1063810034
Name:M&B HOMECARE INC.
Entity type:Organization
Organization Name:M&B HOMECARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:MEADS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:801-825-2081
Mailing Address - Street 1:2121 N 1700 W
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-8803
Mailing Address - Country:US
Mailing Address - Phone:801-825-2081
Mailing Address - Fax:855-327-4739
Practice Address - Street 1:2121 N 1700 W
Practice Address - Street 2:SUITE A
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-8803
Practice Address - Country:US
Practice Address - Phone:801-825-2081
Practice Address - Fax:855-327-4739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2014PCAUT000609251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT=========003Medicaid