Provider Demographics
NPI:1942746318
Name:MATERNITY MENTOR, INC
Entity Type:Organization
Organization Name:MATERNITY MENTOR, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, SBD
Authorized Official - Phone:407-279-7541
Mailing Address - Street 1:315 W CONCORD STREET
Mailing Address - Street 2:222
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1162
Mailing Address - Country:US
Mailing Address - Phone:321-270-4230
Mailing Address - Fax:800-965-5650
Practice Address - Street 1:315 W CONCORD STREET
Practice Address - Street 2:222
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1162
Practice Address - Country:US
Practice Address - Phone:321-270-4230
Practice Address - Fax:800-965-5650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5215602251E00000X, 251J00000X, 251V00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care