Provider Demographics
NPI:1831739069
Name:MMC HOME CARE, LLC
Entity type:Organization
Organization Name:MMC HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-972-2273
Mailing Address - Street 1:368 W PIKE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3240
Mailing Address - Country:US
Mailing Address - Phone:770-972-2273
Mailing Address - Fax:
Practice Address - Street 1:368 W PIKE ST STE 205
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3240
Practice Address - Country:US
Practice Address - Phone:770-972-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care