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Individual

ELLEN LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1625 WEBB ST, DETROIT, MI 48206-1349
(313) 268-5204
Mailing address
PO BOX 2369, DETROIT, MI 48202-0369
(313) 268-5204
(313) 861-0644

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
08/21/2024
Last updated
08/21/2024
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