Provider Demographics
NPI:1598288474
Name:MOMMIE'S & BABIES HOME CARE LLLP
Entity Type:Organization
Organization Name:MOMMIE'S & BABIES HOME CARE LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARZALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-242-2781
Mailing Address - Street 1:PO BOX 10011
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-0011
Mailing Address - Country:US
Mailing Address - Phone:229-242-2781
Mailing Address - Fax:
Practice Address - Street 1:5336 BRANCH POINT DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-7073
Practice Address - Country:US
Practice Address - Phone:229-242-2781
Practice Address - Fax:229-516-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA092-R-1834251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care