| NPI | 1033971379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLA MICHELLE PREWITT Lpn 248-770-0310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-28 |