Provider Demographics
NPI:1396185062
Name:BUNDLES OF JOY
Entity type:Organization
Organization Name:BUNDLES OF JOY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KEYONNA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:LLBSW
Authorized Official - Phone:313-304-4334
Mailing Address - Street 1:6879 LAKEVIEW BLVD
Mailing Address - Street 2:APT 4205
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5805
Mailing Address - Country:US
Mailing Address - Phone:313-304-4334
Mailing Address - Fax:248-415-6268
Practice Address - Street 1:6879 LAKEVIEW BLVD
Practice Address - Street 2:APT 4205
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-5805
Practice Address - Country:US
Practice Address - Phone:313-304-4334
Practice Address - Fax:248-415-6268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management