| NPI | 1194445189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA LAY Provider/Director 313-790-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2023-12-07 |