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General NPI Number Information
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NPI Number | 1447090014
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Entity Type | Organization
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Legal Business Name | OUR NEIGHBORHOOD ACADEMY
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 3096 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-1302
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Country | US
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Telephone | 248-556-5332
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Fax |
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Provider Business Mailing Address
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Address Line | 3096 12 MILE RD
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City | BERKLEY
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State | MI
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Zip | 48072-1302
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Country | US
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Telephone | 248-556-5332
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Fax |
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Authorized Official
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Title or Position | FOUNDER, DIRECTOR
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Name | MS. ALLISON E GREENE
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Credential | TEACHER
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Telephone | 248-930-9959
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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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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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