Provider Demographics
NPI:1134122450
Name:MMM HOME CARE INC
Entity Type:Organization
Organization Name:MMM HOME CARE INC
Other - Org Name:HOME CARE UNLIMITED OF EL PASO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-757-1373
Mailing Address - Street 1:1160 AIRWAY BLVD
Mailing Address - Street 2:STE B6
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3600
Mailing Address - Country:US
Mailing Address - Phone:915-757-1373
Mailing Address - Fax:915-779-9814
Practice Address - Street 1:1160 AIRWAY BLVD
Practice Address - Street 2:STE B6
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3600
Practice Address - Country:US
Practice Address - Phone:915-757-1373
Practice Address - Fax:915-779-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007099251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007099OtherLICENSE
TX024435201Medicaid
TX024435201Medicaid