LAVONA ANGELA WISE

INKSTER, MI
NPI1386234607
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy3104A0625X Assisted Living Facility, Assisted Living, Mental Illness
Additional Taxonomies251E00000X Home Health
Enumeration Date2021-01-20
Last Update Date2021-06-08
Business Address
LAVONA ANGELA WISE
28925 GLENWOOD ST
INKSTER, MI 48141
Phone number: 313-461-8691
Mailing Address
LAVONA ANGELA WISE
28925 GLENWOOD ST
INKSTER, MI 48141-1625
Phone number: 313-461-8691