NPI | 1043830359 |
---|---|
Entity Type | Organization |
Authorized Contact | JULIANNA IVORY Owner 313-926-7813 |
Organization Subpart ? | No |
Primary Taxonomy | 251E00000X Home Health |
Additional Taxonomies | 251S00000X |
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 |