Organization
BONNER HOUSE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEEAUNDRA CHILDRESS RN (CHIEF EXECUTIVE OFFICER)
(248) 804-1372
Entity
Organization
Contact information
Practice address
13892 COLLINGHAM DR, DETROIT, MI 48205-1213
(248) 804-1372
Mailing address
468 STRAIT LN, WAXAHACHIE, TX 75165-0136
(248) 804-1372
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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