Provider Demographics
NPI:1497275283
Name:MMH HOME CARE STAFFING CORP
Entity Type:Organization
Organization Name:MMH HOME CARE STAFFING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:HARDWARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-245-1802
Mailing Address - Street 1:200 13TH AVE UNIT 16A2
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6839
Mailing Address - Country:US
Mailing Address - Phone:646-245-1802
Mailing Address - Fax:631-360-3469
Practice Address - Street 1:200 13TH AVE UNIT 16A2
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6839
Practice Address - Country:US
Practice Address - Phone:646-245-1802
Practice Address - Fax:631-360-3469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01750696746OtherNON-MEDICARE