Provider Demographics
NPI:1154833309
Name:M & M PERSONAL CARE SERVICES LLC
Entity Type:Organization
Organization Name:M & M PERSONAL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:OKEREKE
Authorized Official - Middle Name:MOSES
Authorized Official - Last Name:MADUBUIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-450-8409
Mailing Address - Street 1:2032 CROSBYTON LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-8867
Mailing Address - Country:US
Mailing Address - Phone:214-450-8409
Mailing Address - Fax:
Practice Address - Street 1:2032 CROSBYTON LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-8867
Practice Address - Country:US
Practice Address - Phone:214-450-8409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000000000000261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care