MEDICARE: WELL MOMS HAVE WELL BABIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1649588294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL MOMS HAVE WELL BABIES

Provider Business Mailing Address
First Line	:	3340 MCPHERSON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48212-2668
Country	:	US
Telephone Number	:	313-623-0818
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 MCPHERSON ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48212-2668
Country	:	US
Telephone Number	:	313-623-0818
Fax Number	:

Authorized Official
Title or Position	:	MIHP DIRECTOR
Name	:	AZIZA MICHELLE MUHAMMAD
Credential	:	R.N.
Telephone Number	:	313-623-0818

Provider Enumeration Date	:	09/16/2010
Last Update Date	:	09/16/2010

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Directions to “WELL MOMS HAVE WELL BABIES ” Practice Location

Language	Start Address	Practice Location

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