MEDICARE: NEW BEGINNINGS FOR MOMMY AND ME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205423068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BEGINNINGS FOR MOMMY AND ME LLC

Provider Business Mailing Address
First Line	:	3846 W WISCONSIN AVE APT 101
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-3175
Country	:	US
Telephone Number	:	414-391-1842
Fax Number	:

Provider Business Practice Location Address
First Line	:	3846 W WISCONSIN AVE APT 101
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53208-3175
Country	:	US
Telephone Number	:	414-391-1842
Fax Number	:

Authorized Official
Title or Position	:	PNCC
Name	:	MRS. GLORIA BAXTER
Credential	:
Telephone Number	:	414-391-1842

Provider Enumeration Date	:	12/28/2020
Last Update Date	:	02/24/2022

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Directions to “NEW BEGINNINGS FOR MOMMY AND ME LLC ” Practice Location

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