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1346685575
KATHLEEN MARIE ELLIS
FENTON, MI
NPI
1346685575
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
313M00000X Nursing Facility/Intermediate Care Facility
(Licence: MI 5502001225)
Enumeration Date
2013-05-01
Last Update Date
2013-05-01
Business Address
Mrs. KATHLEEN MARIE ELLIS LPTA
512 BEACH ST
FENTON, MI 48430-3122
Phone number: 810-629-4117
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Mailing Address
Mrs. KATHLEEN MARIE ELLIS LPTA
11182 E RICHFIELD RD
DAVISON, MI 48423-8517
Phone number: 810-252-9888
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