| NPI | 1144079633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA JORDAN Administrator 313-605-0641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-05-16 |
| Last Update Date | 2024-05-16 |