Organization
RESTART VETERANS FOSTER HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMELYN BESEM (OWNER/ADMINISTRATOR)
(480) 276-1466
Entity
Organization
Contact information
Practice address
2105 LAKEVIEW DR, SUITE # 135, YPSILANTI, MI 48198-6754
(480) 276-7144
Mailing address
2105 LAKEVIEW DR, SUITE # 135, YPSILANTI, MI 48198-6754
(480) 276-1466
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
06/20/2015
Last updated
06/20/2015
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