| NPI | 1033635891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS MARIE SLEDGE Provider 313-350-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-14 |