Mama Homecare LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MAMA HOMECARE LLC

Practice address

510 6TH Avenue N
Ste B
Fargo, ND 58102

Phone

(480) 886-7148

NPI assigned

Dec 26, 2024

Organization subpart

No

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

Authorized official

Name

Boniface Makunyi

Title

General Manager

Phone

(480) 886-7148

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1790593531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 6TH AVENUE N",
            "address_2": "STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 6TH AVENUE N",
            "address_2": "STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58102",
            "telephone_number": "480-886-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMA HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-26",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "MAKUNYI",
        "authorized_official_first_name": "BONIFACE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "480-886-7148"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inna Malostovker, MD
• Tracie Malsom, OD
• Katarina Malterud
• Jennifer Jean Malusky, LPN
• Sherry Maly, RN
• Rushana Manatova, MD
• Michael David Manchak, M.D.
• Orville S Mandan, LAC
• Ani Celine Mangold, PHD, LP
• Saraswathy Nonesupplied Manickavasagam, MBBS

• In Home Supportive Care Agency in Fargo, ND
• Providers in Fargo, ND by specialty
• In Home Supportive Care Agency in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.