Organization
MIZPAH GROUP HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALONZO KEVIN MORGAN SR. MA (PRESIDENT)
(248) 796-2639
Entity
Organization
Contact information
Practice address
31058 WHEATON, 201, NEW HUDSON, MI 48165-9469
(248) 796-2639
Mailing address
31058 WHEATON, 201, NEW HUDSON, MI 48165-9469
(248) 796-2639
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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