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General NPI Number Information
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NPI Number | 1649716804
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Entity Type | Organization
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Legal Business Name | LIVING AND LEARNING ENRICHMENT CENTER
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Dates
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Enumeration Date | 01/12/2017
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 315 GRISWOLD ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1615
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Country | US
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Telephone | 248-308-3592
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Fax | 248-773-8686
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Provider Business Mailing Address
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Address Line | 801 GRISWOLD ST
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City | NORTHVILLE
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State | MI
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Zip | 48167-1673
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Country | US
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Telephone | 248-308-3592
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Fax | 248-773-8686
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | RACHELLE VARTANIAN
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Credential |
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Telephone | 248-308-3592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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