MEDICARE: MRS. MERCY MOTAKA NJEA EPSE MANGOH SR. HHA

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	374U00000X	Home Health Aide	HH200004944	MD

General Provider Information

NPI Number	:	1922955285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MERCY MOTAKA NJEA EPSE MANGOH SR. HHA

Provider Business Mailing Address
First Line	:	9513 MUIRKIRK RD APT 101
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-2765
Country	:	US
Telephone Number	:	240-486-8908
Fax Number	:	240-486-8908

Provider Business Practice Location Address
First Line	:	9513 MUIRKIRK RD APT 101
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-2765
Country	:	US
Telephone Number	:	240-486-8908
Fax Number	:	240-486-8908

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/14/2026

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