Healthcare Provider Details

I. General information

NPI: 1437915931
Provider Name (Legal Business Name): WITHMOTHER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BURTON LN
HAMBURG NY
14075-4338
US

IV. Provider business mailing address

6 BURTON LN
HAMBURG NY
14075-4338
US

V. Phone/Fax

Practice location:
  • Phone: 716-202-8133
  • Fax:
Mailing address:
  • Phone: 716-202-8813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: CANDIDA JOHNSON
Title or Position: OWNER
Credential: COMPANION/MOBILE HHS
Phone: 716-202-8813