Provider Demographics
NPI:1093588386
Name:MOMMY'S HELPER POSTPARTUM IN HOME HELP SERVICE LLC
Entity type:Organization
Organization Name:MOMMY'S HELPER POSTPARTUM IN HOME HELP SERVICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JOEVONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-836-6326
Mailing Address - Street 1:5614 N FRESNO ST STE 111
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-6034
Mailing Address - Country:US
Mailing Address - Phone:559-578-0306
Mailing Address - Fax:
Practice Address - Street 1:5614 N FRESNO ST STE 111
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6034
Practice Address - Country:US
Practice Address - Phone:559-578-0306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093588386Medicaid