NPI 1215579537

Eden Prairie Residential Care Services, LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Flint, MI

Practice location

Address: 302 Welch Blvd, Flint, MI 48503-1105
Phone: (214) 250-6576
Fax: (810) 337-1546

Authorised official

Name: Kehinde Olugbolahan Ogundipe
Title: Administrator
Phone: (214) 250-6576

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1215579537
Entity type: Organization
NPI issued: 9 Oct 2019
Record last updated: 9 Oct 2019

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.