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General NPI Number Information
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NPI Number | 1255993473
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Entity Type | Organization
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Legal Business Name | CAMP ZIP OF MICHIGAN
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 111 S WALLACE BLVD
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City | YPSILANTI
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State | MI
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Zip | 48197-4644
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Country | US
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Telephone | 313-405-7041
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Fax |
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Provider Business Mailing Address
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Address Line | 47554 W HURON RIVER DR
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-4400
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Country | US
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Telephone | 734-634-9793
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULLEE LYNN KAZEN
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Credential |
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Telephone | 313-405-7041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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