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General NPI Number Information
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NPI Number | 1184048761
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Entity Type | Organization
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Legal Business Name | BIRCHWOOD MEADOWS, LLC
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 6510 TOWN CENTER DR SUITE B
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City | CLARKSTON
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State | MI
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Zip | 48346-4822
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Country | US
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Telephone | 248-620-8890
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Fax |
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Provider Business Mailing Address
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Address Line | 6510 TOWN CENTER DR SUITE B
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City | CLARKSTON
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State | MI
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Zip | 48346-4822
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Country | US
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Telephone | 248-620-8890
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANIS MEREDITH-KELTERBORN
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Credential |
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Telephone | 248-620-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | AM250086017
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License Number State | MI
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