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Ms. Laura Lisa Gonzalez, MA
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Davison, Michigan
NPI 1770199507

Laura Lisa Gonzalez is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Flint, MI. Laura Lisa Gonzalez practices in Davison, MI and has the professional credentials of MA. The NPI Number for Laura Lisa Gonzalez is 1770199507 and holds a License No. AS25.293461 (Michigan).

The current practice location address for Laura Lisa Gonzalez is 7134 Blankenship Cir, Davison, MI and can be reached out via phone at 810-742-7713 and via fax at 810-407-9198.

Location: 7134 Blankenship Cir, Davison, MI, 48505-2087
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770199507
Provider Name
Laura Lisa Gonzalez
Credential
MA
Provider Entity Type
Individual
Gender
Female
Address
7134 Blankenship Cir, Davison, MI, 48505-2087
Phone Number
810-742-7713
Fax Number
810-407-9198
Provider Enumeration Date
09/17/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7134 Blankenship Cir
City
Davison
State
Michigan
Zip
48423-2317
Phone Number
810-742-7713
Fax Number
810-407-9198
person
Provider Business Mailing Address Details
Address
7134 Blankenship Cir
City
Davison
State
Michigan
Zip
48423-2317
Phone Number
810-742-7713
Fax Number
810-407-9198
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
AS25.293461 (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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