Doctor Name: | MRS. DEBORAH KAY GODERRE |
NPI Number: | 1376814277 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | AF030249722 |
Business Practice Address: | 1620 20th St Allegan, MI - 490109014 |
Business Phone Number: | 2696729722 |
Business Fax Number: | |
Mailing Address: | 1620 20th St, ALLEGAN |
State: | MI |
Postal Code: | 490109014 |
Phone Number: | 2696729722 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2012 |
NPI Last Update Date: | 01/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | AF030249722 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Custodial Care Facility |
Taxonomy Specialization: | Adult Care Home |
Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |