Provider Demographics
NPI:1972322121
Name:MMA COMMUNITY HEALTH LLP
Entity type:Organization
Organization Name:MMA COMMUNITY HEALTH LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNY
Authorized Official - Middle Name:
Authorized Official - Last Name:EUGENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-281-9722
Mailing Address - Street 1:2518 CHAPALA DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-3445
Mailing Address - Country:US
Mailing Address - Phone:845-281-9722
Mailing Address - Fax:
Practice Address - Street 1:6291 LYTERS LN
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-4622
Practice Address - Country:US
Practice Address - Phone:845-281-9722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services