Individual
MS. JAYNE ANN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AFC PROVIDER
Contact information
Practice address
831 ROSE AVENUE, BIG RAPIDS, MI 49307
(231) 796-4512
Mailing address
831 ROSE AVENUE, BIG RAPIDS, MI 49307
(231) 796-4512
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AF540281082
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1098248
—
MI
Enumeration date
12/02/2019
Last updated
12/02/2019
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