Organization
ALL IS WELL MATERNAL INFANT HEALTH PROGRAM
Active
Other names
Legacy of All is Well 365, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TREVA L GORDON RN (PROGRAM COORDINATOR)
(313) 418-2902
Entity
Organization
Contact information
Practice address
49 TUXEDO ST, HIGHLAND PARK, MI 48203-3532
(313) 657-3558
Mailing address
49 TUXEDO ST, HIGHLAND PARK, MI 48203-3532
(313) 418-2902
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/01/2025
Last updated
12/16/2025
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