| NPI | 1235542960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNSON UZOMAA ODUKA Provider/CEO 313-575-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: none) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: VT none) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-06-10 |