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Organization
EDEN PRAIRIE RESIDENTIAL CARE SERVICES, LLC
Active
Organization
EDEN PRAIRIE RESIDENTIAL CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEHINDE OLUGBOLAHAN OGUNDIPE (ADMINISTRATOR)
(214) 250-6576
Entity
Organization
Contact information
Practice address
302 WELCH BLVD, FLINT, MI 48503-1105
(214) 250-6576
(810) 337-1546
Mailing address
302 WELCH BLVD, FLINT, MI 48503-1105
(214) 250-6576
(810) 337-1546
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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