Provider Demographics
NPI:1124556790
Name:MOMMY'S NEW BEGINNING SERVICES, LLC
Entity type:Organization
Organization Name:MOMMY'S NEW BEGINNING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ORGANIZATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-737-0440
Mailing Address - Street 1:5303 N 50TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3408
Mailing Address - Country:US
Mailing Address - Phone:414-737-0440
Mailing Address - Fax:
Practice Address - Street 1:5303 N 50TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-3408
Practice Address - Country:US
Practice Address - Phone:414-737-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty