MEDICARE: MOTHERHOOD CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538893045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTHERHOOD CARE, LLC

Provider Business Mailing Address
First Line	:	2201 MURFREESBORO PIKE STE D-109
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-3327
Country	:	US
Telephone Number	:	615-295-6217
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 MURFREESBORO PIKE STE D-109
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37217-3327
Country	:	US
Telephone Number	:	615-295-6217
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ASKALE HADERA
Credential	:
Telephone Number	:	615-295-6217

Provider Enumeration Date	:	07/11/2022
Last Update Date	:	07/11/2022

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Directions to “MOTHERHOOD CARE, LLC ” Practice Location

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