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Organization

SPENCER MANOR LIVING WELL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICIA MARIE ROYSTER (OWNER)
(810) 744-2777
Entity
Organization

Contact information

Practice address
2219 S TERM ST, BURTON, MI 48519-1030
(810) 744-2777
Mailing address
2219 S TERM ST, BURTON, MI 48519-1030

Taxonomy

Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
AS250306594
MI

Other

Enumeration date
05/29/2012
Last updated
05/29/2012
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