Modern Melanated Mothers

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MODERN MELANATED MOTHERS

Practice address

109 Willowick Dr
Lithonia, GA 30038-1725

Phone

(678) 520-0696

NPI assigned

Jun 23, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deniece Williams

Title

Lactation Doula

Phone

(678) 520-0696

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1356756944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WILLOWICK DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WILLOWICK DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381725",
            "telephone_number": "678-520-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MELANATED MOTHERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DENIECE",
        "authorized_official_title_or_position": "LACTATION DOULA",
        "authorized_official_telephone_number": "678-520-0696"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Lithonia, GA
• Providers in Lithonia, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.