Organization
TENISHA'S ADULT FOSTER CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TENISHA ANN MULLEN (HOME PROVIDER)
12483908128
Entity
Organization
Contact information
Practice address
73 FAIRGROVE ST, PONTIAC, MI 48342-2309
(248) 390-8128
Mailing address
73 FAIRGROVE ST, PONTIAC, MI 48342-2309
(248) 390-8128
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
MI
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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