Provider Demographics
NPI:1114801875
Name:UNIVERSAL MOM, INC
Entity type:Organization
Organization Name:UNIVERSAL MOM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAVAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FOXX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-368-8941
Mailing Address - Street 1:1290 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4398
Mailing Address - Country:US
Mailing Address - Phone:404-368-8941
Mailing Address - Fax:
Practice Address - Street 1:1290 REDBUD DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4398
Practice Address - Country:US
Practice Address - Phone:404-368-8941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No251300000XAgenciesLocal Education Agency (LEA)
No251S00000XAgenciesCommunity/Behavioral Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)