Provider Demographics
NPI:1477862092
Name:MIRACLES FOR MOM'S AND BABES
Entity Type:Organization
Organization Name:MIRACLES FOR MOM'S AND BABES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZA
Authorized Official - Middle Name:YULONDA
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW, MA
Authorized Official - Phone:248-432-7385
Mailing Address - Street 1:31843 KINGSWOOD SQ
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1221
Mailing Address - Country:US
Mailing Address - Phone:313-289-2637
Mailing Address - Fax:
Practice Address - Street 1:31843 KINGSWOOD SQ
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1221
Practice Address - Country:US
Practice Address - Phone:313-289-2637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251300000XAgenciesLocal Education Agency (LEA)