Organization
MISSIONARY SERVANTS OF DIVINE PROVIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTINA UDEAGHA (PRESIDENT/ADMINISTRATOR)
(734) 560-5014
Entity
Organization
Contact information
Practice address
26629 HOPKINS ST, INKSTER, MI 48141-3111
(734) 560-5014
Mailing address
26629 HOPKINS ST, INKSTER, MI 48141-3111
(734) 560-5014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704294907
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295275584
—
MI
Enumeration date
03/10/2017
Last updated
03/10/2017
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