Provider Demographics
NPI:1962653733
Name:CAMERON A F C
Entity Type:Organization
Organization Name:CAMERON A F C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARIE
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-687-7957
Mailing Address - Street 1:14299 WEIR RD
Mailing Address - Street 2:
Mailing Address - City:CLIO
Mailing Address - State:MI
Mailing Address - Zip Code:48420-8853
Mailing Address - Country:US
Mailing Address - Phone:810-687-7957
Mailing Address - Fax:810-687-7797
Practice Address - Street 1:14294 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420-8843
Practice Address - Country:US
Practice Address - Phone:810-686-7045
Practice Address - Fax:810-687-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities