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General NPI Number Information
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NPI Number | 1992015341
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Entity Type | Organization
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Legal Business Name | SMALL TREASURES MATERNAL INFANT HEALTH PROGRAM
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/31/2010
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Provider Practice Location Address
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Address Line | 29193 NORTHWESTERN HWY SUITE 692
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1011
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Country | US
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Telephone | 248-289-3227
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Fax |
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Provider Business Mailing Address
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Address Line | 29193 NORTHWESTERN HWY SUITE 692
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1011
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Country | US
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Telephone | 313-459-1869
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LA'TONYA BROWN
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Credential |
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Telephone | 248-289-3227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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