Organization
SHAW PERSONAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ANN SHAW (OFFICE MANAGER)
(269) 436-1112
Entity
Organization
Contact information
Practice address
45850 60TH ST, LAWRENCE, MI 49064-8600
(269) 621-0601
Mailing address
45850 60TH ST, LAWRENCE, MI 49064-8600
(269) 621-0601
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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