Provider Demographics
NPI:1730053448
Name:MODOLA SERVICES LLC
Entity type:Organization
Organization Name:MODOLA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:EBUNOLUWA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOBOLAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-204-5373
Mailing Address - Street 1:1440 SE BISHOP DR APT 210
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8793
Mailing Address - Country:US
Mailing Address - Phone:414-204-5373
Mailing Address - Fax:
Practice Address - Street 1:1440 SE BISHOP DR APT 210
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8793
Practice Address - Country:US
Practice Address - Phone:414-204-5373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-04
Last Update Date:2025-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty