Provider Demographics
NPI:1497165286
Name:MATERNAL MANAGEMENT LLC
Entity Type:Organization
Organization Name:MATERNAL MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOVEMBER
Authorized Official - Middle Name:SHERREL
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LL, BSW
Authorized Official - Phone:734-207-1036
Mailing Address - Street 1:5860 N CANTON CENTER RD
Mailing Address - Street 2:SUITE 329
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2687
Mailing Address - Country:US
Mailing Address - Phone:734-207-0136
Mailing Address - Fax:734-207-0137
Practice Address - Street 1:5860 N CANTON CENTER RD
Practice Address - Street 2:SUITE 329
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2687
Practice Address - Country:US
Practice Address - Phone:734-207-0136
Practice Address - Fax:734-207-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health