Individual provider · Type 1 NPI
Shari Blackburn
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Fort Gratiot, MI
Practice location
3399 Oxbow Dr
Fort Gratiot, MI 48059-4124
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | AF740302832 (MI) |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
About NPI 1174850002
Shari Blackburn's National Provider Identifier is 1174850002, issued on Nov 13, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Fort Gratiot, MI. The record was last updated on Nov 13, 2009.