Organization
MOTHER STRONG MATERNAL INFANT HEALTH PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONTINE WALLACE RN (RN/COORDINATOR/SOLE MEMBER)
(989) 600-9399
Entity
Organization
Contact information
Practice address
5430 OWEN RD, LINDEN, MI 48451-9024
(989) 600-9399
Mailing address
5430 OWEN RD, LINDEN, MI 48451-9024
(989) 600-9399
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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