MEDICARE: MATERNAL WORKS DVELOPMENTAL SERVICES

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	251E00000X	Home Health Agency	E3780C	MI

General Provider Information

NPI Number	:	1649687427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATERNAL WORKS DVELOPMENTAL SERVICES

Provider Business Mailing Address
First Line	:	751 ABERTON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48215-3374
Country	:	US
Telephone Number	:	313-910-9389
Fax Number	:

Provider Business Practice Location Address
First Line	:	751 ABERTON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48215-3374
Country	:	US
Telephone Number	:	313-910-9389
Fax Number	:

Authorized Official
Title or Position	:	CEO / OWNER
Name	:	MS. ARTELIA JUANITA GRIGGS
Credential	:
Telephone Number	:	313-910-9389

Provider Enumeration Date	:	07/14/2014
Last Update Date	:	07/14/2014

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Directions to “MATERNAL WORKS DVELOPMENTAL SERVICES ” Practice Location

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