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General NPI Number Information
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NPI Number | 1922545037
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Entity Type | Organization
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Legal Business Name | LITTLE TOTS & MOMS CIRCLE OF LIFE, LLC
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 16250 NORTHLAND DR SUITE #241
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5205
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Country | US
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Telephone | 248-359-6204
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Fax | 248-359-6203
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Provider Business Mailing Address
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Address Line | 6689 ORCHARD LAKE RD #328
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3404
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Country | US
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Telephone | 248-359-6204
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Fax | 248-359-6203
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. MARLENE CLARKE
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Credential |
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Telephone | 248-320-8495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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