Healthcare Provider Details

I. General information

NPI: 1518377886
Provider Name (Legal Business Name): MATERNAL BEGINNINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 06/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18301 E 8 MILE RD STE 109
EASTPOINTE MI
48021-3226
US

IV. Provider business mailing address

18301 E 8 MILE RD STE 109
EASTPOINTE MI
48021-3226
US

V. Phone/Fax

Practice location:
  • Phone: 313-633-5644
  • Fax: 586-779-8511
Mailing address:
  • Phone: 313-633-5644
  • Fax: 586-779-8511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: SHONNISE WOODS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 313-633-5644