Provider Demographics
NPI:1104798263
Name:MADRES HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:MADRES HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAGADALENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTEMASANGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-606-6242
Mailing Address - Street 1:9711 WASHINGTONIAN BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5789
Mailing Address - Country:US
Mailing Address - Phone:301-250-8368
Mailing Address - Fax:
Practice Address - Street 1:9711 WASHINGTONIAN BLVD STE 550
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5789
Practice Address - Country:US
Practice Address - Phone:301-250-8368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care