Organization
IDEAL TREASURE CARE AFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGINA NJERI MUGO (OWNER)
(269) 414-9598
Entity
Organization
Contact information
Practice address
6710 EVERGREEN ST, PORTAGE, MI 49024-3220
(269) 414-9598
(269) 254-8187
Mailing address
6710 EVERGREEN ST, PORTAGE, MI 49024-3220
(269) 414-9598
(269) 254-8187
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M200734631762
—
MI
Enumeration date
05/19/2022
Last updated
04/30/2024
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