# MAMA HOME CARE, LLC

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

## Provider details

- **NPI number:** 1295500114
- **Authorized official:** ALEXIS DAVID KIM (ADMINISTRATOR)
- **Authorized official phone:** (702) 738-0515

## Contact information

- **Practice address:** 1401 ARVILLE ST STE G, LAS VEGAS, NV 89102-0537
- **Practice address phone:** (702) 738-0515
- **Practice address fax:** (702) 527-7698
- **Mailing address:** 1401 ARVILLE ST STE G, LAS VEGAS, NV 89102-0537
- **Mailing address phone:** (702) 738-0515
- **Mailing address fax:** (702) 527-7698

## Taxonomy

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

## Other

- **Enumeration date:** 11/21/2023
- **Last updated:** 09/29/2024