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Organization
MOMMY & MENTORS MIHP, LLC
Active
Organization
MOMMY & MENTORS MIHP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENID ALEXANDRA MOORE (OWNER)
(734) 377-8841
Entity
Organization
Contact information
Practice address
40946 CROSSBOW CIR APT 201, CANTON, MI 48188-3156
(734) 377-8841
Mailing address
40946 CROSSBOW CIR APT 201, CANTON, MI 48188-3156
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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