=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427490044
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMFORTING MOMS AND BABIES,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2013
-----------------------------------------------------
Last Update Date | 07/24/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17250 W 12 MILE RD STE 111
-----------------------------------------------------
City | SOUTHFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48076-2127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-395-5265
-----------------------------------------------------
Fax | 248-395-5266
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17250 W 12 MILE RD STE 111
-----------------------------------------------------
City | SOUTHFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48076-2127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-395-5265
-----------------------------------------------------
Fax | 248-395-5266
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. NICOLE DENISE BROWN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 248-395-5265
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------