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General NPI Number Information
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NPI Number | 1457512469
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Entity Type | Organization
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Legal Business Name | HOME LIFE STYLES INC
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 27230 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-1918
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Country | US
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Telephone | 586-498-8990
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Fax | 586-498-8993
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Provider Business Mailing Address
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Address Line | 27230 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48081-1918
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Country | US
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Telephone | 586-498-8990
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Fax | 586-498-8993
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Authorized Official
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Title or Position | DIRECTOR, RESIDENTIAL SERVICES
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Name | MRS. DEBORAH MARIE SAMMUT
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Credential |
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Telephone | 586-498-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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