Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHARI BLACKBURN
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · FORT GRATIOT, MI
Registration Details
- NPI Number
- 1174850002
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 13, 2009 (16.437475439035 yrs)
- Last Updated
- Nov 13, 2009
- License
-
AF740302832 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3399 OXBOW DRFORT GRATIOT, MI, 480594124Browse MI providers · Browse ZIP 48059
- Phone
- 8109908134
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.