Organization
FONTAINE HOUSING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFFORD COELHO (OWNER)
(313) 597-1135
Entity
Organization
Contact information
Practice address
4095 W PHILADELPHIA ST, DETROIT, MI 48204-2446
(313) 597-1135
Mailing address
4095 W PHILADELPHIA ST, DETROIT, MI 48204-2446
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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