Organization
HIDDEN PEACE SPECIALIZED LIVING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN LEE RUSSELL (ADMINISTRATOR)
(810) 629-8647
Entity
Organization
Contact information
Practice address
10520 HARTLAND RD, FENTON, MI 48430-8704
(810) 629-8647
(810) 629-8839
Mailing address
10520 HARTLAND RD, FENTON, MI 48430-8704
(810) 629-8647
(810) 629-8839
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AF470301064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2361285
—
MI
Enumeration date
06/16/2011
Last updated
06/16/2011
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