Provider Demographics
NPI:1790341188
Name:MM HOME CARE, LLC
Entity Type:Organization
Organization Name:MM HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:PSYCHAS
Authorized Official - Last Name:CIARLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-461-1122
Mailing Address - Street 1:PO BOX 49396
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0078
Mailing Address - Country:US
Mailing Address - Phone:704-461-1122
Mailing Address - Fax:
Practice Address - Street 1:3816 BLAND RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6239
Practice Address - Country:US
Practice Address - Phone:919-348-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MM HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-12
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCHC3352OtherSTATE OF NORTH CAROLINA