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General NPI Number Information
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NPI Number | 1427717750
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Entity Type | Organization
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Legal Business Name | MOMMYS DAY OFF, LLC
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 2806 LANDRUM DR SW
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City | ATLANTA
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State | GA
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Zip | 30311-4302
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Country | US
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Telephone | 240-413-3103
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Fax |
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Provider Business Mailing Address
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Address Line | 8491 HOSPITAL DR # 444
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2412
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Country | US
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Telephone | 706-804-2468
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TREJONDA MOMENT
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Credential |
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Telephone | 706-804-2468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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