# LISA GAHN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lisa Howard
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710435938
- **Authorized official:** LISA MAE GAHN (COTA)
- **Authorized official phone:** (740) 491-2623

## Contact information

- **Practice address:** 9570 JOHN WERNER DR, CHEBOYGAN, MI 49721-9411
- **Practice address phone:** (740) 491-2623
- **Mailing address:** 9570 JOHN WERNER DR, CHEBOYGAN, MI 49721-9411
- **Mailing address phone:** (740) 491-2623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 4 | MI | Yes |

## Other

- **Enumeration date:** 09/16/2016
- **Last updated:** 07/21/2022