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General NPI Number Information
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NPI Number | 1962653733
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Entity Type | Organization
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Legal Business Name | CAMERON A F C
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 14294 N SAGINAW RD
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City | CLIO
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State | MI
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Zip | 48420-8843
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Country | US
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Telephone | 810-686-7045
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Fax | 810-687-7797
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Provider Business Mailing Address
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Address Line | 14299 WEIR RD
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City | CLIO
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State | MI
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Zip | 48420-8853
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Country | US
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Telephone | 810-687-7957
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Fax | 810-687-7797
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Authorized Official
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Title or Position | OWNER
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Name | MS. SHARIE KAY CAMERON
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Credential |
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Telephone | 810-687-7957
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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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