Organization
TWIN DOVES III LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKIE HERNANDEZ (OWNER)
(616) 403-9430
Entity
Organization
Contact information
Practice address
52101 34TH AVE, BANGOR, MI 49013
(616) 403-9430
(269) 852-5910
Mailing address
34130 52ND ST, BANGOR, MI 49013-9727
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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