Healthcare Provider Details
I. General information
NPI: 1992503080
Provider Name (Legal Business Name): CHEERFUL MOMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2025
Last Update Date: 03/19/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 SUTTER ST STE 500
CONCORD CA
94520-2587
US
IV. Provider business mailing address
1271 MONUMENT BLVD APT 78
CONCORD CA
94520-4455
US
V. Phone/Fax
- Phone: 925-655-8169
- Fax:
- Phone: 925-655-8169
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ABDULLAH
AL
MAHUMD
Title or Position: CEO
Credential: OWNER
Phone: 925-655-8169