Provider Demographics
NPI:1821737388
Name:MAMA816 LLC
Entity Type:Organization
Organization Name:MAMA816 LLC
Other - Org Name:HOME HELPERS - DIRECT LINK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOKOLUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-551-5231
Mailing Address - Street 1:4191 FORD DR
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-5365
Mailing Address - Country:US
Mailing Address - Phone:610-551-5231
Mailing Address - Fax:
Practice Address - Street 1:600 EAGLEVIEW BLVD STE 300
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1224
Practice Address - Country:US
Practice Address - Phone:610-551-5231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health