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General NPI Number Information
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NPI Number | 1770455479
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Entity Type | Organization
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Legal Business Name | MLMHHC SERVICES LLC
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 19378 COUNTY ROUTE 162
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City | WATERTOWN
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State | NY
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Zip | 13601-5449
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Country | US
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Telephone | 315-783-3259
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Fax |
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Provider Business Mailing Address
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Address Line | 19378 COUNTY ROUTE 162
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City | WATERTOWN
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State | NY
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Zip | 13601-5449
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Country | US
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Telephone | 315-783-3259
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Fax |
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Authorized Official
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Title or Position | LICENSE PRACTICAL NURSE
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Name | MS. MARTINA L MARCINKO
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Credential | LPN
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Telephone | 315-783-3259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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