NPI 1265818850

Health Full Elements

Organisation Contractor Warren, MI

Practice location

Address: 11443 E 13 Mile Rd 404, Warren, MI 48093-2589
Phone: (586) 216-0990
Mailing address: 25797 Curie Ave, Warren, MI 48091-3829

Authorised official

Name: Dawn Jakubowski
Title: Owner; Manager
Phone: (586) 216-0990

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence 7501004559 (MI)

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Registry record

NPI: 1265818850
Entity type: Organization
NPI issued: 5 Aug 2015
Record last updated: 5 Aug 2015

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.