MEDICARE: YMOA INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	261QC1500X	Community Health Clinic/Center
3	332U00000X	Home Delivered Meals
4	347C00000X	Private Vehicle
5	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1871347385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YMOA INC

Provider Business Mailing Address
First Line	:	9823 EBYWOOD LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-9742
Country	:	US
Telephone Number	:	571-298-7618
Fax Number	:

Provider Business Practice Location Address
First Line	:	916 W COLISEUM BLVD STE G
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46808-1291
Country	:	US
Telephone Number	:	571-298-7618
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER / CEO
Name	:	MRS. TASHA NICOLE DAVIS
Credential	:	DOULA
Telephone Number	:	571-298-7618

Provider Enumeration Date	:	04/12/2024
Last Update Date	:	04/12/2024

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Directions to “YMOA INC ” Practice Location

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