Reella Lee Burrell

NPI #1184143463 in Portage, Michigan

Provider Information

NPI Number: 1184143463
Entity Type: Individual
Name: Reella Lee Burrell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Sep 18, 2017
Last Updated: Sep 18, 2017

Practice Location

Address: 6345 ANGLING RD
City: Portage
State: Michigan
ZIP Code: 49024-1703
Phone: (269) 312-8885

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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