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Brenda White
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Warren, Michigan
NPI 1295258010

Brenda White is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Warren, MI. Brenda White practices in Warren, MI. The NPI Number for Brenda White is 1295258010 and holds a License No. AF500286756 (Michigan).

The current practice location address for Brenda White is 21180 Gentner St, Warren, MI and can be reached out via phone at 586-774-9559.

Location: 21180 Gentner St, Warren, MI, 48089-3437
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295258010
Provider Name
Brenda White
Credential
Provider Entity Type
Individual
Gender
Female
Address
21180 Gentner St, Warren, MI, 48089-3437
Phone Number
586-774-9559
Fax Number
Provider Enumeration Date
07/24/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
21180 Gentner St
City
Warren
State
Michigan
Zip
48089-3437
Phone Number
586-774-9559
Fax Number
person
Provider Business Mailing Address Details
Address
21180 Gentner St
City
Warren
State
Michigan
Zip
48089-3437
Phone Number
586-774-9559
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
AF500286756 (Michigan)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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