Organization
IN HOUSE HOSPITALITY
Active
Organization
IN HOUSE HOSPITALITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVA LYNETTE GORDON RN (SOLE PROPIETOR)
(313) 465-0304
Entity
Organization
Contact information
Practice address
15481 MANOR ST, DETROIT, MI 48238-1670
(313) 465-0304
Mailing address
15481 MANOR ST, DETROIT, MI 48238-1670
(313) 465-0304
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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