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Dalena S Moman
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Kalamazoo, Michigan
NPI 1295999894

Dalena S Moman is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Kalamazoo, MI. Dalena S Moman practices in Kalamazoo, MI. The NPI Number for Dalena S Moman is 1295999894 and holds a License No. AF390069743 (Michigan).

The current practice location address for Dalena S Moman is 1022 Royce Ave, Kalamazoo, MI and can be reached out via phone at 269-343-8480 and via fax at 269-343-5773.

Location: 1022 Royce Ave, Kalamazoo, MI, 49001-4993
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295999894
Provider Name
Dalena S Moman
Credential
Provider Entity Type
Individual
Gender
Female
Address
1022 Royce Ave, Kalamazoo, MI, 49001-4993
Phone Number
269-343-8480
Fax Number
269-343-5773
Provider Enumeration Date
07/12/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1022 Royce Ave
City
Kalamazoo
State
Michigan
Zip
49001-4993
Phone Number
269-343-8480
Fax Number
269-343-5773
person
Provider Business Mailing Address Details
Address
1022 Royce Ave
City
Kalamazoo
State
Michigan
Zip
49001-4993
Phone Number
269-343-8480
Fax Number
269-343-5773
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.
AF390069743 (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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