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General NPI Number Information
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NPI Number | 1548475452
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Entity Type | Organization
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Legal Business Name | INDEPENDENT OPPORTUNITIES OF MICHIGAN, INC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 45199 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5508
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Country | US
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Telephone | 586-739-9220
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Fax | 586-739-3321
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Provider Business Mailing Address
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Address Line | 45199 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5508
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Country | US
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Telephone | 586-739-9220
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Fax | 586-739-3321
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Authorized Official
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Title or Position | INTERIM EXECUTIVE DIRECTOR
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Name | MRS. LESLIE MARIE G SALVANI
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Credential | B.S.
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Telephone | 586-739-9220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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