NPI 1760196224
Twin Doves III LLC
Practice location
- Address
- 52101 34th Ave, Bangor, MI 49013
- Phone
- (616) 403-9430
- Fax
- (269) 852-5910
- Mailing address
- 34130 52nd St, Bangor, MI 49013-9727
Authorised official
- Name
- Rickie Hernandez
- Title
- Owner
- Phone
- (616) 403-9430
Registered specialties
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1760196224
- Entity type
- Organization
- NPI issued
- 10 Jan 2023
- Record last updated
- 10 Jan 2023
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.