Organization
ADVANCED ADULT FOSTER CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WAYNE MINIAT MI, DD (PRESIDENT)
(269) 760-9692
Entity
Organization
Contact information
Practice address
202 CORWIN MEADOWS DR, LAWRENCE, MI 49064-9548
(269) 674-3051
(269) 674-3051
Mailing address
PO BOX 371, PAW PAW, MI 49079-0371
(269) 674-3051
(269) 674-3051
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS800315037
MI
Other
Enumeration date
01/29/2016
Last updated
01/29/2016
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