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Organization

CREEKWOOD TRAIL ADULT FOSTER CARE HOME

Active
Other names
Creekwood Trail Family Home
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROLYN ANN WILSON (HOME CARE PROVIDER)
(248) 625-0869
Entity
Organization

Contact information

Practice address
10078 CREEKWOOD TRAIL, DAVISBURG, MI 48350-2058
(248) 625-0869
(248) 620-9403
Mailing address
10078 CREEKWOOD TRL, 240 O'RILEY COURT, DAVISBURG, MI 48350-2058
(248) 625-0869
(248) 620-9403

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
AS630277210
MI

Other

Enumeration date
03/17/2010
Last updated
03/17/2010
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