Organization
CANDACE MATHEWS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE RENEE MATHEWS (PARENT)
(517) 795-1752
Entity
Organization
Contact information
Practice address
117 E ADDISON ST, JACKSON, MI 49203-4301
(517) 795-1752
Mailing address
117 E ADDISON ST, JACKSON, MI 49203-4301
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
385H00000X
MI
Other
Enumeration date
03/21/2010
Last updated
03/21/2010
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