Organization
MABEL AVENUE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ANN LEWIS (OWNER)
(810) 820-7279
Entity
Organization
Contact information
Practice address
1446 MABEL AVE, FLINT, MI 48506-3343
(810) 820-7279
(810) 820-7279
Mailing address
1446 MABEL AVE, FLINT, MI 48506-3343
(810) 820-7279
(810) 820-7279
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
AS250337649
MI
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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