Provider Demographics
NPI:1568114155
Name:MOMENTS HOSPICE OF MANKATO LLC
Entity Type:Organization
Organization Name:MOMENTS HOSPICE OF MANKATO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIYAHU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-800-0908
Mailing Address - Street 1:124 E WALNUT ST STE 330
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6558
Mailing Address - Country:US
Mailing Address - Phone:507-609-8800
Mailing Address - Fax:507-609-8810
Practice Address - Street 1:124 E WALNUT ST STE 330
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6558
Practice Address - Country:US
Practice Address - Phone:507-609-8800
Practice Address - Fax:507-609-8810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based