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General NPI Number Information
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NPI Number | 1104415124
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Entity Type | Organization
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Legal Business Name | NURTURING CONNECTIONS L.L.C.
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 20474 VINE DR
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City | MACOMB
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State | MI
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Zip | 48044-6501
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Country | US
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Telephone | 313-283-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 20474 VINE DR
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City | MACOMB
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State | MI
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Zip | 48044-6501
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Country | US
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Telephone | 313-283-9868
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AQEELA R MUNTAQIM
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Credential | CLS
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Telephone | 313-757-2616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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