Provider Demographics
NPI:1700631694
Name:MOFEY HOME CARE LLC
Entity Type:Organization
Organization Name:MOFEY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADEDEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-551-2736
Mailing Address - Street 1:3989 CANNING ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46122-6010
Mailing Address - Country:US
Mailing Address - Phone:317-551-2736
Mailing Address - Fax:
Practice Address - Street 1:3989 CANNING ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-6010
Practice Address - Country:US
Practice Address - Phone:317-551-2736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care