Individual
LINDA LEE HAVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 E FARRAND RD, CLIO, MI 48420-9149
(810) 686-8390
Mailing address
2410 E FARRAND RD, CLIO, MI 48420-9149
(810) 686-8390
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AF250001791
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0339997
—
MI
Enumeration date
10/28/2008
Last updated
10/28/2008
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