| NPI | 1104069673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSERATIN TINU UWAIFO Manager 313-478-1374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251E00000X Home Health |
| 261Q00000X Clinic/Center | |
| 261QA0600X Clinic/Center Adult Day Care | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MI AS820294357) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2023-04-18 |