Provider Demographics
NPI:1730931544
Name:MIND OVER MATTER M O M CLEANING SERVICES LLC
Entity type:Organization
Organization Name:MIND OVER MATTER M O M CLEANING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:INDIA
Authorized Official - Middle Name:DOSHINQUE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-290-0907
Mailing Address - Street 1:7601 MELODY CIR W
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46816-4875
Mailing Address - Country:US
Mailing Address - Phone:608-290-0907
Mailing Address - Fax:
Practice Address - Street 1:7601 MELODY CIR W
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46816-4875
Practice Address - Country:US
Practice Address - Phone:608-290-0907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care