Organization
BLUE WATER DEVELOPMENTAL HOUSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE C KILBOURNE (SUPPORT WORKER)
(810) 388-1200
Entity
Organization
Contact information
Practice address
1600 GRATIOT BLVD, MARYSVILLE, MI 48040-1145
(810) 388-1200
Mailing address
1600 GRATIOT BLVD, MARYSVILLE, MI 48040-1145
(810) 388-1200
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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