Organization
LYDIAS HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA HODGES (OWNER)
(616) 844-3059
Entity
Organization
Contact information
Practice address
11667 152ND AVE, WEST OLIVE, MI 49460-9232
(616) 844-3059
Mailing address
11667 152ND AVE, WEST OLIVE, MI 49460-9232
(616) 844-3059
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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