Provider Demographics
NPI:1376415430
Name:MISSION HOME CARE LLC
Entity type:Organization
Organization Name:MISSION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-900-4141
Mailing Address - Street 1:100 LARRABEE RD STE 150
Mailing Address - Street 2:OFFICE 102
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4796
Mailing Address - Country:US
Mailing Address - Phone:207-900-4141
Mailing Address - Fax:
Practice Address - Street 1:100 LARRABEE RD STE 150
Practice Address - Street 2:OFFICE 102
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4796
Practice Address - Country:US
Practice Address - Phone:207-900-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care