Provider Demographics
NPI:1366251688
Name:MAHLET HOME CARE LLC
Entity type:Organization
Organization Name:MAHLET HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TARIKUA
Authorized Official - Middle Name:K
Authorized Official - Last Name:TESFAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-584-8850
Mailing Address - Street 1:1715 LINNERUD DR PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-8902
Mailing Address - Country:US
Mailing Address - Phone:214-584-8850
Mailing Address - Fax:
Practice Address - Street 1:1016 NEW HAVEN CIR
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-8902
Practice Address - Country:US
Practice Address - Phone:214-584-8850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-01
Last Update Date:2025-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home