| NPI | 1336336817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JORDAN Exectuive Director 248-399-8115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2013-05-23 |