Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rustic Ridge Specialized Residential

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1972471159

Rustic Ridge Specialized Residential is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Grand Blanc, Michigan. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

6624 Rustic Ridge Trl
Grand Blanc, MI 48439-4955
Phone: (833) 478-9464
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X

Record details

NPI number1972471159
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Breanna Moslander — Hr Admin · (833) 478-9464
NPI enumeratedOctober 28, 2025
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025
Mailing address3060 S Dye Rd, Flint, MI 48507-1078