Organization
MOMBA HOME CARE IND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAZAR HUISMAN (PRESIDENT)
(404) 418-7484
Entity
Organization
Contact information
Practice address
550 CONGRESSIONAL BLVD STE 115, CARMEL, IN 46032-5644
(317) 765-0016
Mailing address
150 ZEBLIN RD, SANDY SPRINGS, GA 30342-2048
(718) 902-7022
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
05/29/2025
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