Provider Demographics
NPI:1558443754
Name:MO MO INCORPORATED
Entity Type:Organization
Organization Name:MO MO INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:541-922-1750
Mailing Address - Street 1:1890 7TH ST
Mailing Address - Street 2:
Mailing Address - City:UMATILLA
Mailing Address - State:OR
Mailing Address - Zip Code:97882-9826
Mailing Address - Country:US
Mailing Address - Phone:541-922-1750
Mailing Address - Fax:541-922-1753
Practice Address - Street 1:1890 7TH ST
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:OR
Practice Address - Zip Code:97882-9826
Practice Address - Country:US
Practice Address - Phone:541-922-1750
Practice Address - Fax:541-922-1753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR135333Medicare UPIN
ORR135332Medicare UPIN