Provider Demographics
NPI:1710639232
Name:HEALTHY MOM HEALTHY BABY LLC
Entity Type:Organization
Organization Name:HEALTHY MOM HEALTHY BABY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-933-6439
Mailing Address - Street 1:5215 N IRONWOOD RD STE 202-22
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4915
Mailing Address - Country:US
Mailing Address - Phone:414-933-6439
Mailing Address - Fax:
Practice Address - Street 1:7873 W BECKETT AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-5320
Practice Address - Country:US
Practice Address - Phone:414-933-6439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty