Provider Demographics
NPI:1811342785
Name:A & A MATERNAL INFANT HEALTH SERVICES, INC,
Entity type:Organization
Organization Name:A & A MATERNAL INFANT HEALTH SERVICES, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:C
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-215-2026
Mailing Address - Street 1:42364 SILVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-2940
Mailing Address - Country:US
Mailing Address - Phone:586-215-2026
Mailing Address - Fax:586-275-5637
Practice Address - Street 1:42364 SILVERWOOD DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-2940
Practice Address - Country:US
Practice Address - Phone:586-215-2026
Practice Address - Fax:586-275-5637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health