Provider Demographics
NPI:1356823769
Name:FATHERS, MOTHERS AND INFANTS, LLC
Entity Type:Organization
Organization Name:FATHERS, MOTHERS AND INFANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-727-8327
Mailing Address - Street 1:9254 TRINITY ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-1633
Mailing Address - Country:US
Mailing Address - Phone:248-727-8327
Mailing Address - Fax:313-340-9658
Practice Address - Street 1:9254 TRINITY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-1633
Practice Address - Country:US
Practice Address - Phone:248-727-8327
Practice Address - Fax:313-340-9658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care