Provider Demographics
NPI:1538893045
Name:MOTHERHOOD CARE, LLC
Entity type:Organization
Organization Name:MOTHERHOOD CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASKALE
Authorized Official - Middle Name:
Authorized Official - Last Name:HADERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-295-6217
Mailing Address - Street 1:2201 MURFREESBORO PIKE STE D-109
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-3327
Mailing Address - Country:US
Mailing Address - Phone:615-295-6217
Mailing Address - Fax:
Practice Address - Street 1:2201 MURFREESBORO PIKE STE D-109
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-3327
Practice Address - Country:US
Practice Address - Phone:615-295-6217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI000000021089Medicaid