Organization
BURNETT AFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA M BURNETT (OWNER/LICENSEE)
(810) 743-6291
Entity
Organization
Contact information
Practice address
2181 KENNETH ST, BURTON, MI 48529-1358
(810) 743-6291
(810) 743-1579
Mailing address
2181 KENNETH ST, BURTON, MI 48529-1358
(810) 743-6291
(810) 743-1579
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
AM250067081
MI
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AM250067081
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5294486
—
MI
Enumeration date
10/07/2008
Last updated
10/07/2008
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