Organization
THE MANOR HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETTY ANN REYNOLDS-MACIEJEWSKI (OWNER)
12319470463
Entity
Organization
Contact information
Practice address
1258 LAKE DR, TRAVERSE CITY, MI 49684-8288
(123) 194-7046
Mailing address
1258 LAKE DR, TRAVERSE CITY, MI 49684-8288
(123) 194-7046
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
AF280260935
MI
Other
Enumeration date
06/07/2009
Last updated
06/07/2009
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