Organization
GUNDEN AFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY GUNDEN (HOME PROVIDER)
(989) 588-6769
Entity
Organization
Contact information
Practice address
16 KAPPLINGER DR, FARWELL, MI 48622-9405
(989) 588-6769
Mailing address
PO BOX 129, FARWELL, MI 48622-0129
(989) 588-6769
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS180010543
MI
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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