Healthcare Provider Details

I. General information

NPI: 1265738165
Provider Name (Legal Business Name): HEALTHY MOMS AND BABIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2011
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8449 W PARKWAY ST
DETROIT MI
48239-1157
US

IV. Provider business mailing address

8449 W PARKWAY ST
DETROIT MI
48239-1157
US

V. Phone/Fax

Practice location:
  • Phone: 313-598-0095
  • Fax: 313-274-2835
Mailing address:
  • Phone: 313-598-0095
  • Fax: 313-274-2835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: MS. KANICA HARRIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 313-598-0095