# MOMBA HOME CARE GA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174211593
- **Authorized official:** ELAZAR HUISMAN (NPI MANAGER)
- **Authorized official phone:** (404) 418-7484

## Contact information

- **Practice address:** 150 ZEBLIN RD, SANDY SPRINGS, GA 30342-2048
- **Practice address phone:** (718) 902-7022
- **Mailing address:** 150 ZEBLIN RD, SANDY SPRINGS, GA 30342-2048
- **Mailing address phone:** (718) 902-7022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/25/2023
- **Last updated:** 05/29/2025