Healthcare Provider Details
I. General information
NPI: 1851158836
Provider Name (Legal Business Name): MOKA HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9431 E MEXICO AVE
DENVER CO
80247-3040
US
IV. Provider business mailing address
9431 E MEXICO AVE
DENVER CO
80247-3040
US
V. Phone/Fax
- Phone: 720-933-9984
- Fax:
- Phone: 720-933-9984
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MALAK
ELDIE
Title or Position: OWNER
Credential:
Phone: 720-933-9984