Individual
MRS. LEANN RENEE GASTELUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DIRECTOR
Contact information
Practice address
19301 WINTHROP ST, DETROIT, MI 48235
(702) 559-8224
Mailing address
19301 WINTHROP ST, DETROIT, MI 48235
(702) 559-8224
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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