Provider Demographics
NPI:1265738165
Name:HEALTHY MOMS AND BABIES
Entity type:Organization
Organization Name:HEALTHY MOMS AND BABIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KANICA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-598-0095
Mailing Address - Street 1:8449 W PARKWAY ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48239-1157
Mailing Address - Country:US
Mailing Address - Phone:313-598-0095
Mailing Address - Fax:313-274-2835
Practice Address - Street 1:8449 W PARKWAY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48239-1157
Practice Address - Country:US
Practice Address - Phone:313-598-0095
Practice Address - Fax:313-274-2835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care