Greenley Square Manor

NPI #1326299660 in Burton, Michigan

Provider Information

NPI Number: 1326299660
Entity Type: Organization
Organization Name: Greenley Square Manor
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Oct 6, 2008
Last Updated: Oct 6, 2008

Practice Location

Address: 1345 CONNELL ST
City: Burton
State: Michigan
ZIP Code: 48529-2201
Phone: (810) 743-5011

Authorized Official

Name: MR. TIMOTHY DOUGLAS BERTRAM, R.N.
Title: ADMINISTRATOR
Phone: (810) 743-5011

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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