Organization
MCMASTER RESIDENTIAL HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE OEHRING (EXECUTIVE ADMINISTRATOR)
(248) 310-9173
Entity
Organization
Contact information
Practice address
1710 N PONTIAC TRL, WALLED LAKE, MI 48390-3151
(248) 310-9173
(248) 624-2269
Mailing address
1710 N PONTIAC TRL, WALLED LAKE, MI 48390-3151
(248) 310-9173
(248) 624-2269
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AS630012284
MI
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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