Organization
NANNIEGALES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YOUNG GLENISE FERRA LICENSEE (ADMINISTRATOR)
(313) 704-4071
Entity
Organization
Contact information
Practice address
27421 MARSHALL ST, SOUTHFIELD, MI 48076-5142
(313) 704-4071
(313) 704-4071
Mailing address
27421 MARSHALL ST, SOUTHFIELD, MI 48076-5142
(313) 704-4071
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/31/2025
Last updated
10/31/2025
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