Individual provider · Type 1 NPI
Kathy Peterson
Intellectual and/or Developmental Disabilities Residential Treatment Facility · St. Ignace, MI
Practice location
PO Box 307
St. Ignace, MI 49781-0307
Fax (906) 984-2028
Mailing address
N881 Gros Cap Rd
St. Ignace, MI 49781-9837
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | AS490300190 (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 1407601644
Kathy Peterson's National Provider Identifier is 1407601644, issued on Apr 22, 2024. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in St. Ignace, MI. The record was last updated on Apr 22, 2024.