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General NPI Number Information
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NPI Number | 1467660688
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Entity Type | Organization
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Legal Business Name | DOMEL INCORPORATED
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 39293 PLYMOUTH RD STE 112
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City | LIVONIA
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State | MI
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Zip | 48150-1060
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Country | US
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Telephone | 734-632-0125
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Fax | 734-632-0126
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Provider Business Mailing Address
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Address Line | 39293 PLYMOUTH RD STE 112
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City | LIVONIA
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State | MI
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Zip | 48150-1060
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Country | US
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Telephone | 734-632-0125
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Fax | 734-632-0126
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Authorized Official
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Title or Position | EXECUTIVE PROGRAM MANAGER
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Name | SHAWN TIMOTHY BROWN
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Credential |
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Telephone | 734-632-0125
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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 | MI
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Taxonomy #2
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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 | MI
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Taxonomy #3
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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 | MI
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Taxonomy #4
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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 | MI
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Taxonomy #5
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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 | MI
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Taxonomy #6
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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 | MI
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Taxonomy #7
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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 | MI
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Taxonomy #8
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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 | MI
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Taxonomy #9
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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 | MI
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Taxonomy #10
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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 | MI
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