Organization
OTEVWA HOMES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIVE EVWARAYE (DIRECTOR)
(313) 690-0667
Entity
Organization
Contact information
Practice address
6556 RUSTIC RIDGE TRL, GRAND BLANC, MI 48439-4956
(313) 690-0667
Mailing address
6556 RUSTIC RIDGE TRL, GRAND BLANC, MI 48439-4956
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/29/2020
Last updated
08/29/2020
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