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General NPI Number Information
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NPI Number | 1992138184
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Entity Type | Organization
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Legal Business Name | DAVID'S HOUSE MINISTRIES
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2390 BANNER DR SW
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City | WYOMING
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State | MI
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Zip | 49509-1930
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Country | US
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Telephone | 616-247-7861
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Fax |
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Provider Business Mailing Address
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Address Line | 2390 BANNER DR SW
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City | WYOMING
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State | MI
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Zip | 49509-1930
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Country | US
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Telephone | 616-247-7861
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANN BRAFORD
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Credential |
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Telephone | 616-726-1702
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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 | MI
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