Organization
REBECCA MAE FORBES
Active
Other names
Blue Moon House
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA MAE FORBES (SOLE PROPRIETOR)
(269) 521-4500
Entity
Organization
Contact information
Practice address
130 45TH ST, BLOOMINGDALE, MI 49026-9502
(269) 521-4500
Mailing address
130 45TH ST, BLOOMINGDALE, MI 49026-9502
(269) 521-4500
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS030265913
MI
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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