Organization
MOMBA HOME CARE OHIO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAZAR HUISMAN (NPI MANAGER)
(404) 418-7484
Entity
Organization
Contact information
Practice address
4555 LAKE FOREST DR STE 580, BLUE ASH, OH 45242-3785
(216) 255-9022
Mailing address
400 PERIMETER CENTER TER NE STE 300, ATLANTA, GA 30346-1201
(800) 553-3495
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
04/20/2026
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