Organization
LARRY'S FULL SERVICE SALON
Active
Parent organization
LARRY CLAYBAUGH,JR.
Other names
state of michigan
Organization subpart
Yes
Provider details
NPI number
Legal business name
LARRY CLAYBAUGH,JR.
Authorized official
MR. LARRY EUGENE CLAYBAUGH JR. CAREGIVER (OPPERATOR)
(989) 544-2200
Entity
Organization
Contact information
Practice address
10658 ALPINE DR, LAKE, MI 48632-9722
(989) 544-2200
Mailing address
10658 ALPINE DR, LAKE, MI 48632-9722
(989) 544-2200
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
1865788
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1865788
STATE OF MICHIGAN HOME HELP CARE PROVIDER#1865788(2003)-PRESENT
MI
Enumeration date
01/31/2012
Last updated
01/31/2012
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