IndividualActive
Brenda White
NPI 1295258010 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Warren, MI
Provider details
- NPI number
- 1295258010
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- AF500286756 (MI)
Mailing address
21180 Gentner St
Warren, MI 48089-3437
Registry dates
- Enumerated
- 2017-07-24
- Last updated
- 2017-07-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.