Provider Demographics
NPI:1588347439
Name:ESI MENSIMAH LLC
Entity type:Organization
Organization Name:ESI MENSIMAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KOJO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARBRAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-552-6997
Mailing Address - Street 1:1433 N WATER ST FL 5
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2557
Mailing Address - Country:US
Mailing Address - Phone:414-552-6997
Mailing Address - Fax:
Practice Address - Street 1:9730 W BLUEMOUND RD STE 4
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-4463
Practice Address - Country:US
Practice Address - Phone:414-552-6997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health