Individual provider · Type 1 NPI
Dalena S. Moman
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Kalamazoo, MI
Practice location
1022 Royce Ave
Kalamazoo, MI 49001-4993
Fax (269) 343-5773
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | AF390069743 (MI) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1295999894
Dalena S. Moman's National Provider Identifier is 1295999894, issued on Jul 12, 2008. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Kalamazoo, MI. The record was last updated on Jul 12, 2008.