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General NPI Number Information
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NPI Number | 1962168278
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Entity Type | Organization
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Legal Business Name | MOM VILLAGE, LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 4910 HARFORD RD STE 1
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City | BALTIMORE
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State | MD
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Zip | 21214-2964
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Country | US
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Telephone | 443-449-7335
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 HARFORD RD STE 1
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City | BALTIMORE
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State | MD
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Zip | 21214-2964
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Country | US
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Telephone | 410-205-6603
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHERITTA N GRIER
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Credential |
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Telephone | 410-205-6603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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