person
Mrs. Deshra Michelle Vines
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Flint, Michigan
NPI 1255576765

Deshra Michelle Vines is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Flint, MI. Deshra Michelle Vines practices in Flint, MI. The NPI Number for Deshra Michelle Vines is 1255576765 and holds a License No. AS250263327 (Michigan).

The current practice location address for Deshra Michelle Vines is 714 Lippincott Blvd, Flint, MI and can be reached out via phone at 810-233-6696 and via fax at 810-233-6696. You can also correspond with Deshra Michelle Vines through the mailing address at 714 LIPPINCOTT BLVD, FLINT, MI - 48503-5818 (mailing address contact number: 810-233-6696).

Location: 714 Lippincott Blvd, Flint, MI, 48503-5818
person
Provider Profile Details
NPI Number
1255576765
Provider Name
Deshra Michelle Vines
Credential
Provider Entity Type
Individual
Gender
Female
Address
714 Lippincott Blvd, Flint, MI, 48503-5818
Phone Number
810-233-6696
Fax Number
810-233-6696
Provider Enumeration Date
12/11/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9099470 01 MI DHS PROVIDER ID NUMBER
institution
Provider Business Practice Location Address Details
Address
714 Lippincott Blvd
City
State
Zip
48503-5818
Phone Number
810-233-6696
Fax Number
810-233-6696
person
Provider Business Mailing Address Details
Address
714 Lippincott Blvd
City
State
Zip
48503-5818
Phone Number
810-233-6696
Fax Number
810-233-6696
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
AS250263327 (Michigan)
Definition
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.
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