Provider Demographics
NPI:1871373050
Name:MOMBA HOME CARE ALABAMA
Entity type:Organization
Organization Name:MOMBA HOME CARE ALABAMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF GOVERNMENT AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:ADON
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-962-1033
Mailing Address - Street 1:999 PEACHTREE ST NE STE 1500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4421
Mailing Address - Country:US
Mailing Address - Phone:404-962-1033
Mailing Address - Fax:
Practice Address - Street 1:2100 SOUTHBRIDGE PKWY UNIT 650
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1317
Practice Address - Country:US
Practice Address - Phone:659-272-0084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care