Organization
LAKE FENTON HAUS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN MARIE HUBER EXECUTIVE DIRECTOR (OWNER EXECUTIVE DIRECTOR)
(810) 629-7969
Entity
Organization
Contact information
Practice address
12287 MARGARET DR, FENTON, MI 48430
(810) 629-7969
Mailing address
12287 MARGARET DR, FENTON, MI 48430
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/09/2006
Last updated
08/22/2020
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