| NPI | 1437235140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL PATRICK Home Provider 313-341-2827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: MI AS820068122) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2024-05-16 |