Mboka Community Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

MBOKA COMMUNITY SERVICES, LLC

Practice address

3514 Ramona Ave
Louisville, KY 40220-2411

Phone

(502) 671-9908

NPI assigned

Sep 14, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elizabeth Bass, RN

Title

Co-Owner

Phone

(502) 671-9908

Specialties & licenses 3

Addresses

Tax ID family

Mboka Community Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mboka Community Services, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Louisville, KY
  • NPI 1194630764
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1104603836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3514 RAMONA AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402202411",
            "telephone_number": "502-671-9908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3514 RAMONA AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402202411",
            "telephone_number": "502-671-9908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBOKA COMMUNITY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "502-671-9908",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Mazzone, PT, DPT
• Robert Lee Mazzoni, RPH
• MB Investors (Caterra Health Systems)
• MB Investors Dba Caterra Health Systems
• Okey Patrick Mbadike, PHARNCIST
• Mboka Community Services, LLC
• Brooke McAfee, NP
• Debra Lou McAfee, LPN
• Jeffery L. McAfee, MD
• Katie Ryan McAfee, LBA

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.