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Individual

LEONA ROSSBACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
29225 UTICA RD, ROSEVILLE, MI 48066-4624
(586) 773-7094
Mailing address
29225 UTICA RD, ROSEVILLE, MI 48066-4624
(586) 773-7094

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AF500287496
MI

Other

Enumeration date
06/19/2017
Last updated
07/21/2022
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