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Organization

DIVINE TRANSFORMATIONS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROSALIINE WHITE (ADMINISTRATOR)
(248) 298-9217
Entity
Organization

Contact information

Practice address
18151 SANTA ANN AVE, LATHRUP VILLAGE, MI 48076-4523
(248) 569-3582
Mailing address
18151 SANTA ANN AVE, LATHRUP VILLAGE, MI 48076-4523
(248) 569-3582

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AS630301996
MI

Other

Enumeration date
01/09/2011
Last updated
01/09/2011
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