Healthcare Provider Details

I. General information

NPI: 1447611967
Provider Name (Legal Business Name): LOVING MOTHERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 03/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52962 WENDOVER DR
SHELBY TWP MI
48316-2965
US

IV. Provider business mailing address

52962 WENDOVER DR
SHELBY TWP MI
48316-2965
US

V. Phone/Fax

Practice location:
  • Phone: 586-530-0627
  • Fax:
Mailing address:
  • Phone: 586-530-0627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number4704134479
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number4704134479
License Number StateMI

VIII. Authorized Official

Name: MS. SHERAN MARIE OKEH
Title or Position: PROPRITOR
Credential: RN
Phone: 586-530-0627