Kathleen Mary Zorza

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Gwinn, MI

NPI 1962725564 · NPPES record last updated Mar 10, 2010

Key facts

NPI
1962725564
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
AF520239098 (MI)
Practice address
440 S Peninsula LN
Gwinn, MI 49841-9213
Phone
(906) 346-6028
NPI assigned
Mar 10, 2010
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
AF520239098MIMDIntellectual and/or Developmental Disabilities Residential Treatment Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X AF520239098 MI Yes

Addresses

Primary practice location

440 S Peninsula LN
Gwinn, MI 49841-9213

Mailing address

440 S Peninsula LN
Gwinn, MI 49841-9213
Phone (906) 346-6028

Other identifiers

IdentifierTypeStateIssuer
AF520239098OtherMIAFC ADULT CARE

Other providers in Gwinn, MI

All providers in Gwinn, MI · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Michigan

Sources for this page

Verify at the official NPI Registry.