Provider Demographics
NPI:1255746913
Name:MABLE'S WARM EMBRACE LLC
Entity type:Organization
Organization Name:MABLE'S WARM EMBRACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-809-6098
Mailing Address - Street 1:30275 BALEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1526
Mailing Address - Country:US
Mailing Address - Phone:248-809-6098
Mailing Address - Fax:626-605-9052
Practice Address - Street 1:30275 BALEWOOD ST
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1526
Practice Address - Country:US
Practice Address - Phone:248-809-6098
Practice Address - Fax:626-605-9052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-21
Last Update Date:2014-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care