Organization
BERTRAM'S MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS D BURNETT (OWNER/ADMINISTRATOR)
(810) 238-1430
Entity
Organization
Contact information
Practice address
1202 CHURCH ST, FLINT, MI 48502-1015
(810) 238-1430
(810) 238-1447
Mailing address
1202 CHURCH ST, FLINT, MI 48502-1015
(810) 238-1430
(810) 238-1447
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AM250289405
MI
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
AM250289405
MI
Other
Enumeration date
10/06/2008
Last updated
10/06/2008
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