Provider Demographics
NPI:1861706004
Name:MB1, LLC
Entity type:Organization
Organization Name:MB1, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/GM
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-360-0006
Mailing Address - Street 1:1321 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2626
Mailing Address - Country:US
Mailing Address - Phone:615-360-0006
Mailing Address - Fax:615-360-0066
Practice Address - Street 1:1321 MURFREESBORO PIKE
Practice Address - Street 2:SUITE 600
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2626
Practice Address - Country:US
Practice Address - Phone:615-360-0006
Practice Address - Fax:615-360-0066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000007005253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care