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Organization
LAKE FENTON HAUS INC
Active
Organization
LAKE FENTON HAUS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN MARIE HUBER EXECUTIVE DIRECTOR (OWNER EXECUTIVE DIRECTOR)
(810) 629-7969
Entity
Organization
Contact information
Practice address
12287 MARGARET DR, FENTON, MI 48430
(810) 629-7969
Mailing address
12287 MARGARET DR, FENTON, MI 48430
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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