Organization Active NPI

Momba Home Care Ind, LLC

  • In Home Supportive Care Agency
  • Carmel, IN
National Provider Identifier
1124716527
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
MOMBA HOME CARE IND, LLC
Practice address
550 Congressional Blvd Ste 115
Carmel, IN 46032-5644
Phone
(317) 765-0016
NPI assigned
Apr 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elazar Huisman
Title
President
Phone
(404) 418-7484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

550 Congressional Blvd Ste 115
Carmel, IN 46032-5644

Mailing address

150 Zeblin Rd
Sandy Springs, GA 30342-2048
Phone (718) 902-7022

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1124716527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 ZEBLIN RD",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303422048",
            "telephone_number": "718-902-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CONGRESSIONAL BLVD STE 115",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325644",
            "telephone_number": "317-765-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMBA HOME CARE IND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "HUISMAN",
        "authorized_official_first_name": "ELAZAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-418-7484"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.