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Organization

THE MEADOWS SPECIALIZED RESIDENTIAL PROGRAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GINA MARIE KELLY (OWNER/HOME ADMINISTRATOR)
(269) 496-1033
Entity
Organization

Contact information

Practice address
55377 WALTERSPAUGH RD, MENDON, MI 49072-9545
(269) 496-1033
Mailing address
55377 WALTERSPAUGH RD, MENDON, MI 49072-9545
(269) 496-1033

Taxonomy

Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
AS750239107
MI

Other

Enumeration date
11/27/2011
Last updated
11/27/2011
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