Healthcare Provider Details

I. General information

NPI: 1295341279
Provider Name (Legal Business Name): M&M GROUP HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 10TH ST SE
DECATUR AL
35601-4421
US

IV. Provider business mailing address

113 SHADY SPRING DR
HARVEST AL
35749-9657
US

V. Phone/Fax

Practice location:
  • Phone: 678-670-0062
  • Fax:
Mailing address:
  • Phone: 678-670-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: LATASHA RENE HORTON
Title or Position: OWNER
Credential:
Phone: 678-670-0062