IndividualActive
Dalena Moman
NPI 1295999894 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Kalamazoo, MI
Provider details
- NPI number
- 1295999894
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- AF390069743 (MI)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense AF390069743 (MI)
Residential Treatment Facilities
Practice location
1022 Royce Ave
Kalamazoo, MI 49001-4993
Phone: (269) 343-8480
Fax: (269) 343-5773
Approximate (ZIP-level) locationGet directions
Mailing address
1022 Royce Ave
Kalamazoo, MI 49001-4993
Registry dates
- Enumerated
- 2008-07-12
- Last updated
- 2008-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.