MEDICARE: MOM BOARD AND CARE SERVICES INC

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1881550721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOM BOARD AND CARE SERVICES INC

Provider Business Mailing Address
First Line	:	2301 90TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94603-1806
Country	:	US
Telephone Number	:	510-866-6660
Fax Number	:	510-866-6660

Provider Business Practice Location Address
First Line	:	2301 90TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94603-1806
Country	:	US
Telephone Number	:	510-866-6660
Fax Number	:	510-866-6660

Authorized Official
Title or Position	:	CEO
Name	:	FALEMEI M VAI
Credential	:
Telephone Number	:	510-866-6660

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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