MEDICARE: MOMBA HOME CARE MISSOURI, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1578300687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOMBA HOME CARE MISSOURI, LLC

Provider Business Mailing Address
First Line	:	400 PERIMETER CENTER TER NE STE 300
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30346-1201
Country	:	US
Telephone Number	:	314-237-3633
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CHESTERFIELD BUSINESS PKWY FL 2
Second Line	:
City	:	CHESTERFIELD
State	:	MO
Zip	:	63005-1271
Country	:	US
Telephone Number	:	314-237-3633
Fax Number	:

Authorized Official
Title or Position	:	NPI MANAGER
Name	:	ELAZAR HUISMAN
Credential	:
Telephone Number	:	404-418-7484

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	06/18/2026

Similar Medicare Providers

1063538676 — DR. DUSTIN GARTH JAMES MD
Practice Location Address:

100 CHESTERFIELD BUSINESS PKWY STE 110
CHESTERFIELD, MO
63005-1271

Practice Phone: 636-532-0990
Practice Fax: 636-532-0993

1477741239 — CHESTERFIELD VALLEY DERMATOLOGY PC
Practice Location Address:

100 CHESTERFIELD BUSINESS PKWY , SUITE 110
CHESTERFIELD, MO
63005-1271

Practice Phone: 636-532-0990
Practice Fax: 636-532-0993

1770772725 — GREGORY S KRIVONYAK M.D.
Practice Location Address:

100 CHESTERFIELD BUSINESS PKWY FL 2
CHESTERFIELD, MO
63005-1271

Practice Phone: 954-399-4673
Practice Fax: 352-323-2261

1104119916 — CHESTERFIELD VALLEY GASTROENTEROLOGY LLC
Practice Location Address:

100 CHESTERFIELD BUSINESS PKWY STE 110
CHESTERFIELD, MO
63005-1271

Practice Phone: 636-532-0990
Practice Fax: 636-532-0993

1770829608 — HOPE HEALTHCARE, LLC
Practice Location Address:

100 CHESTERFIELD BUSINESS PKWY
CHESTERFIELD, MO
63005-1271

Practice Phone: 314-435-8424
Practice Fax:

1588003842 — MRS. ANDREA SUSANNE ABBOTT FNP-C
Practice Location Address:

100 CHESTERFIELD BUSINESS PKWY FL 2
CHESTERFIELD, MO
63005-1271

Practice Phone: 831-218-6882
Practice Fax: 731-584-2345

Directions to “MOMBA HOME CARE MISSOURI, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.