Organization
MOMMYS LOVE BUG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CARMEN DESIREE WILSON (PRESIDENT)
(248) 894-6462
Entity
Organization
Contact information
Practice address
24853 ARDEN PARK DR, FARMINGTON HILLS, MI 48336-2211
(248) 894-6462
(866) 594-6994
Mailing address
24853 ARDEN PARK DR, FARMINGTON HILLS, MI 48336-2211
(248) 894-6462
(866) 594-6994
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/25/2014
Last updated
02/02/2016
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