Organization
KOUROUMA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANTELLE MORRISON-KOUROUMA RN, M.ED (PRESIDENT)
(313) 402-7812
Entity
Organization
Contact information
Practice address
13560 E MCNICHOLS RD, DETROIT, MI 48205-3426
(313) 402-7812
Mailing address
PO BOX 8235, EASTPOINTE, MI 48021-8235
(313) 402-7812
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
4704258152
MI
251J00000X
Nursing Care Agency
4704258152
MI
251K00000X
Public Health or Welfare Agency
Primary
4704258152
MI
251S00000X
Community/Behavioral Health Agency
4704258152
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316273030
—
MI
05
—
2249265
—
MI
Enumeration date
07/03/2010
Last updated
07/10/2012
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