# ALL IS WELL MATERNAL INFANT HEALTH PROGRAM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Legacy of All is Well 365, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316811474
- **Authorized official:** TREVA L GORDON RN (PROGRAM COORDINATOR)
- **Authorized official phone:** (313) 418-2902

## Contact information

- **Practice address:** 49 TUXEDO ST, HIGHLAND PARK, MI 48203-3532
- **Practice address phone:** (313) 657-3558
- **Mailing address:** 49 TUXEDO ST, HIGHLAND PARK, MI 48203-3532
- **Mailing address phone:** (313) 418-2902

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2025
- **Last updated:** 12/16/2025