Most Relevant Information
Provider Data
| NPI Number: | 1003583402 |
| Provider Name: | SHONDA RUSHING |
| Entity Type: | Individual |
| Taxonomy Code: | 320900000X |
| Specialty: | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/24/2021 |
| Last Updated: | 08/24/2021 |
Provider Practice Location
2941 S GULLEY RD
DEARBORN
MI
481243160
Practice Location Phone/Fax
| Phone: | 3132783040 |
| Fax: |
Provider Mailing Location
2941 S GULLEY RD
DEARBORN
MI
481243160
Provider Mailing Phone/Fax
| Phone: | 3132783040 |
| Fax: |