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General NPI Number Information
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NPI Number | 1013439017
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Entity Type | Organization
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Legal Business Name | A MOTHERS LOVE PRENATAL CARE SERVICES
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 07/11/2017
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Provider Practice Location Address
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Address Line | 500 W SILVER SPRING DR STE K200
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City | GLENDALE
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State | WI
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Zip | 53217-5052
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Country | US
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Telephone | 414-847-6355
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Fax | 414-755-1830
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Provider Business Mailing Address
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Address Line | 8989 N PARK PLAZA CT APT 301
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City | BROWN DEER
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State | WI
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Zip | 53223-2145
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Country | US
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Telephone | 414-477-7842
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Fax | 414-755-1830
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Authorized Official
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Title or Position | RN /OWNER
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Name | REGINA M THOMAS
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Credential | REGISTERED NURSE
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Telephone | 414-477-7842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 189507-30
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License Number State | WI
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