Provider Demographics
NPI:1033579354
Name:MOTHERS HELP CARE INFANT AGENCY
Entity Type:Organization
Organization Name:MOTHERS HELP CARE INFANT AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:B.A PSYCHOLOGY/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLEMENTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-619-3802
Mailing Address - Street 1:17538 12TH AVE. NE.
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155
Mailing Address - Country:US
Mailing Address - Phone:206-619-3802
Mailing Address - Fax:
Practice Address - Street 1:17538 12TH AVE NE
Practice Address - Street 2:B307
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-3720
Practice Address - Country:US
Practice Address - Phone:206-619-3802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603559742372500000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty