Organization
MATERNAL SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN GEEGAN (EXECUTIVE DIRECTOR)
(269) 684-0259
Entity
Organization
Contact information
Practice address
960 AGARD AVE, BENTON HARBOR, MI 49022-4051
(269) 927-5162
(269) 927-5319
Mailing address
960 AGARD AVE, BENTON HARBOR, MI 49022-4051
(269) 927-5162
(269) 927-5319
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4108343
—
MI
Enumeration date
01/15/2007
Last updated
07/29/2008
Update your record
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