Provider Demographics
NPI:1073526349
Name:MAMAD HEALTHCARE, LLC
Entity Type:Organization
Organization Name:MAMAD HEALTHCARE, LLC
Other - Org Name:TOTAL HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT / DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-973-7070
Mailing Address - Street 1:5215 COCONUT CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3916
Mailing Address - Country:US
Mailing Address - Phone:954-973-7070
Mailing Address - Fax:954-973-8545
Practice Address - Street 1:5215 COCONUT CREEK PKWY
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-3916
Practice Address - Country:US
Practice Address - Phone:954-973-7070
Practice Address - Fax:954-973-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA21615096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicare UPIN