Provider Demographics
NPI:1700594355
Name:MP LIVING CARE LLC
Entity Type:Organization
Organization Name:MP LIVING CARE LLC
Other - Org Name:HOMEWELL CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:TSHIKULA
Authorized Official - Last Name:ILUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:134-774-0526
Mailing Address - Street 1:227 SEVENTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6626
Mailing Address - Country:US
Mailing Address - Phone:347-740-5264
Mailing Address - Fax:
Practice Address - Street 1:227 SEVENTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6626
Practice Address - Country:US
Practice Address - Phone:347-740-5264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty