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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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