NPI 1336546589

Five Star Residential INC

Organisation Foster Care Agency Oak Park, MI

Practice location

Address: 22190 Sussex St, Oak Park, MI 48237-3509
Phone: (248) 421-2735
Fax: (248) 677-3082

Authorised official

Name: Judith Tanguaka
Title: Staff Nurse Cardiac ICU
Phone: (248) 421-2735

Registered specialties

Foster Care Agency Primary

Agencies Taxonomy 253J00000X Licence AS630352375 (MI)

Other Foster Care Agency providers in Michigan →

Registry record

NPI: 1336546589
Entity type: Organization
NPI issued: 3 Dec 2014
Record last updated: 3 Dec 2014

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.