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General NPI Number Information
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NPI Number | 1457382194
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Entity Type | Organization
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Legal Business Name | KENT'S ASSISTED LIVING
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 8425 FARRAND RD
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City | MONTROSE
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State | MI
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Zip | 48457-9779
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Country | US
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Telephone | 810-639-3378
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Fax | 810-639-3390
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Provider Business Mailing Address
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Address Line | 8425 FARRAND RD
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City | MONTROSE
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State | MI
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Zip | 48457-9779
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Country | US
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Telephone | 810-639-3378
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Fax | 810-639-3390
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER/DIRECT CARE
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Name | MRS. SHERRY MARIE KENT
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Credential |
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Telephone | 810-639-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | AM250015926
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License Number State | MI
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