MEDICARE: MOTHER'S HELPER COMMUNITY SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1215716089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTHER'S HELPER COMMUNITY SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	6330 NEWTOWN RD STE 200
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-4809
Country	:	US
Telephone Number	:	757-524-4176
Fax Number	:	757-524-4182

Provider Business Practice Location Address
First Line	:	6330 NEWTOWN RD STE 200
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-4809
Country	:	US
Telephone Number	:	757-524-4176
Fax Number	:	757-524-4182

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MIKHAYAH YISHRAEL - CARTER
Credential	:
Telephone Number	:	757-524-5176

Provider Enumeration Date	:	09/21/2023
Last Update Date	:	09/22/2023

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