Provider Demographics
NPI:1760013825
Name:MOM AND POP CAREGIVING AGENCY INC
Entity Type:Organization
Organization Name:MOM AND POP CAREGIVING AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:I
Authorized Official - Last Name:LANDERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-918-9209
Mailing Address - Street 1:1771 E FLAMINGO RD STE 230A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0851
Mailing Address - Country:US
Mailing Address - Phone:310-918-9209
Mailing Address - Fax:702-407-2787
Practice Address - Street 1:1771 E FLAMINGO RD STE 230A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0851
Practice Address - Country:US
Practice Address - Phone:702-476-2840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care