Healthcare Provider Details

I. General information

NPI: 1730805284
Provider Name (Legal Business Name): MONAS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 E SOUTHERN AVE
MESA AZ
85210-5406
US

IV. Provider business mailing address

347 E SOUTHERN AVE
MESA AZ
85210-5406
US

V. Phone/Fax

Practice location:
  • Phone: 623-388-7359
  • Fax:
Mailing address:
  • Phone: 623-388-7359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MAIMUNA NYEMB
Title or Position: PRESIDENT
Credential:
Phone: 480-709-1167