| NPI | 1295127413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY BENTON CEO 313-588-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS820289178) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2015-02-25 |