Organization
MOMBA HOME CARE ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAZAR HUISMAN (NPI MANAGER)
(404) 418-7484
Entity
Organization
Contact information
Practice address
1300 S LITCHFIELD RD STE 115D, GOODYEAR, AZ 85338-1645
(520) 829-0535
Mailing address
400 PERIMETER CENTER TER NE STE 300, ATLANTA, GA 30346-1201
(404) 962-1033
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/04/2023
Last updated
04/21/2026
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