Provider Demographics
NPI:1720644248
Name:A MOTHERS LOVE HOME CARE
Entity Type:Organization
Organization Name:A MOTHERS LOVE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAKASHI
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:LABON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-470-6867
Mailing Address - Street 1:1652 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-1237
Mailing Address - Country:US
Mailing Address - Phone:662-470-6867
Mailing Address - Fax:662-253-8089
Practice Address - Street 1:1652 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-1237
Practice Address - Country:US
Practice Address - Phone:662-470-6867
Practice Address - Fax:662-253-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care