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Organization
REBECCA MAE FORBES
Active
Organization
REBECCA MAE FORBES
Active
Other names
Blue Moon House
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA MAE FORBES (SOLE PROPRIETOR)
(269) 521-4500
Entity
Organization
Contact information
Practice address
130 45TH ST, BLOOMINGDALE, MI 49026-9502
(269) 521-4500
Mailing address
130 45TH ST, BLOOMINGDALE, MI 49026-9502
(269) 521-4500
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS030265913
MI
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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