| NPI | 1043830359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANNA IVORY Owner 313-926-7813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 253J00000X Foster Care Agency | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |