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General NPI Number Information
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NPI Number | 1720450141
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Entity Type | Organization
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Legal Business Name | THE SHARON ELAINE FOUNDATION
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Dates
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Enumeration Date | 10/25/2015
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Last Update Date | 10/25/2015
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Provider Practice Location Address
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Address Line | 38150 METRO VILLA CT UNIT 106K
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City | HARRISON TOWNSHIP
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State | MI
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Zip | 48045-5381
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Country | US
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Telephone | 770-875-2427
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Fax |
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Provider Business Mailing Address
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Address Line | 38150 METRO VILLA CT UNIT 106K
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City | HARRISON TOWNSHIP
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State | MI
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Zip | 48045-5381
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | SHANTEL ROBERTS
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Credential |
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Telephone | 770-875-2427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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