Individual provider · Type 1 NPI
Laura Lisa Gonzalez, M.A
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Davison, MI
Practice location
7134 Blankenship Cir
Davison, MI 48423-2317
Fax (810) 407-9198
Mailing address
510 W Foss Ave
Flint, MI 48505-2087
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | AS25.293461 (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 1770199507
Laura Lisa Gonzalez, M.A's National Provider Identifier is 1770199507, issued on Sep 17, 2020. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Davison, MI. The record was last updated on Sep 17, 2020.