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Organization
THE MOM AND BABY PROGRAM
Active
Organization
THE MOM AND BABY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORETTA ANN TYLER RN BSN (EXECUTIVE DIRECTOR MIHP COORDINATOR)
(248) 838-9665
Entity
Organization
Contact information
Practice address
129 E UNIVERSITY DR, ROCHESTER, MI 48307-2046
(248) 838-9665
(248) 659-5207
Mailing address
129 E UNIVERSITY DR, ROCHESTER, MI 48307-2046
(248) 838-9665
(248) 659-5207
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
4704160228
MI
Other
Enumeration date
07/27/2012
Last updated
12/11/2012
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