Organization
SUJI HOME LLC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
FRIDA REUBEN BOYD (OWNER/LICENSEE)
(269) 207-5965
Entity
Organization
Contact information
Practice address
319 N SAGE ST, KALAMAZOO, MI 49006-4040
(269) 341-4337
Mailing address
319 N SAGE ST, 319 NORTH SAGE STREET, KALAMAZOO, MI 49006-4040
(269) 341-4337
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
AS390383907
MI
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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