Provider Demographics
NPI:1144620337
Name:MOMMY MOMMY LLC
Entity Type:Organization
Organization Name:MOMMY MOMMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NKIRUKA
Authorized Official - Middle Name:V
Authorized Official - Last Name:AHARAUKA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:248-460-3505
Mailing Address - Street 1:6201 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2297
Mailing Address - Country:US
Mailing Address - Phone:248-460-3505
Mailing Address - Fax:248-395-0226
Practice Address - Street 1:6201 CHARLES DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2297
Practice Address - Country:US
Practice Address - Phone:248-460-3505
Practice Address - Fax:248-395-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health