Healthcare Provider Details

I. General information

NPI: 1922948363
Provider Name (Legal Business Name): MMT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6921 SHADOW RIDGE LN
STONE MOUNTAIN GA
30087-4760
US

IV. Provider business mailing address

6921 SHADOW RIDGE LN
STONE MOUNTAIN GA
30087-4760
US

V. Phone/Fax

Practice location:
  • Phone: 678-231-6359
  • Fax:
Mailing address:
  • Phone: 678-231-6359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JERRY TRAPP
Title or Position: OWNER
Credential:
Phone: 678-231-6359