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Organization

KLECK AFC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CONNALEE KLECK (FOSTER MOTHER)
(616) 719-0620
Entity
Organization

Contact information

Practice address
631 3 MILE RD NE, GRAND RAPIDS, MI 49505-3362
(616) 719-0620
Mailing address
631 3 MILE RD NE, GRAND RAPIDS, MI 49505-3362
(616) 719-0620

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AF410284007
MI

Other

Enumeration date
02/14/2017
Last updated
02/14/2017
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