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Organization

GODSCHILD77 LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANE MARIE DEWEY CLIA WAIVED CERT. (CEO/OWNER)
(517) 442-8709
Entity
Organization

Contact information

Practice address
1690 WATERTOWER PL STE 100-214, EAST LANSING, MI 48823-8046
(517) 442-8709
Mailing address
5235 CROCUS AVE, LANSING, MI 48911-3734
(517) 442-8709

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
12/04/2025
Last updated
12/27/2025
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