| NPI | 1295190494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA HODGES Owner/Member 313-909-0115 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2016-11-16 |