NPI 1124310818
Hernandez Home LLC
Practice location
- Address
- 94 45th St, Bloomingdale, MI 49026-9502
- Phone
- (269) 628-2100
- Mailing address
- P.O. Box 277, Bloomingdale, MI 49026
Authorised official
- Name
- Tracie Hernandez
- Title
- Ceo
- Phone
- (269) 628-2100
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1124310818
- Entity type
- Organization
- NPI issued
- 12 May 2011
- Record last updated
- 12 May 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.