Provider Demographics
NPI:1396633673
Name:MJBLK LLC
Entity type:Organization
Organization Name:MJBLK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAEUTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:513-978-8881
Mailing Address - Street 1:6405 BRANCH HILL GUINEA PIKE UNIT 201
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6755
Mailing Address - Country:US
Mailing Address - Phone:513-978-8881
Mailing Address - Fax:
Practice Address - Street 1:6405 BRANCH HILL GUINEA PIKE UNIT 201
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-6755
Practice Address - Country:US
Practice Address - Phone:513-978-8881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care