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Organization

KATHY'S MATERNAL INFANT HEALTH PROGRAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE ANITA THOMPSON LLBSW (EXECUTIVE DIRECTOR)
(248) 320-6992
Entity
Organization

Contact information

Practice address
18446 WESTHAVEN AVE, SOUTHFIELD, MI 48075-4119
(248) 320-6992
(866) 396-4055
Mailing address
18446 WESTHAVEN AVE, SOUTHFIELD, MI 48075-4119
(248) 320-6992
(866) 396-4055

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
6802085964
MI
252Y00000X
Early Intervention Provider Agency
Primary
6802085964
MI

Other

Enumeration date
10/05/2011
Last updated
10/05/2011
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