Organization
JUMP START LLC MATERNAL INFANT HEALTH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH ELIZABETH LEE (MATERNAL INFANT HEALTH PROVIDER)
(313) 587-2963
Entity
Organization
Contact information
Practice address
1086 WILLIAMSON CIR, PONTIAC, MI 48340
(313) 587-2963
Mailing address
1086 WILLIAMSON CIR, PONTIAC, MI 48340-3314
(313) 587-2963
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
302F00000X
MI
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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