Melissa Maria Luna-Keaton

Individual provider Active NPI Foster Care Agency · Mount Morris, MI

NPI 1295986503 · NPPES record last updated Oct 6, 2008

Key facts

NPI
1295986503
Entity type
Individual (NPI type 1)
Primary specialty
Foster Care Agency 253J00000X
License
AS250010894 (MI)
Practice address
5135 E Mount Morris Rd
Mount Morris, MI 48458-9721
Phone
(810) 515-4278
NPI assigned
Oct 6, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AS250010894MIMDFoster Care Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X AS250010894 MI Yes
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X AS250010894 MI

Addresses

Primary practice location

5135 E Mount Morris Rd
Mount Morris, MI 48458-9721

Mailing address

5135 E Mount Morris Rd
Mount Morris, MI 48458-9721
Phone (810) 515-4278

Other providers in Mount Morris, MI

All providers in Mount Morris, MI · Foster Care Agency in Michigan

Sources for this page

Verify at the official NPI Registry.