Healthcare Provider Details

I. General information

NPI: 1477401636
Provider Name (Legal Business Name): MAMLAKAH SLS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2026
Last Update Date: 03/21/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 CAMDEN AVE STE 205-0
SAN JOSE CA
95124-2942
US

IV. Provider business mailing address

1900 CAMDEN AVE STE 205-0
SAN JOSE CA
95124-2942
US

V. Phone/Fax

Practice location:
  • Phone: 408-509-3292
  • Fax:
Mailing address:
  • Phone: 408-509-3292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name: SULIANA ULUINAQARAVATU
Title or Position: OWNER/CHIEF ADMINISTRATOR
Credential:
Phone: 408-509-3292