Provider Demographics
NPI:1659156131
Name:MOMA GOOD INC
Entity Type:Organization
Organization Name:MOMA GOOD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-378-8622
Mailing Address - Street 1:PO BOX 563
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-0563
Mailing Address - Country:US
Mailing Address - Phone:724-312-8669
Mailing Address - Fax:
Practice Address - Street 1:225 SIXTH AVE
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-3458
Practice Address - Country:US
Practice Address - Phone:724-378-8622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOMA GOOD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency