| NPI | 1457836553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH SLEDGE Vice President 313-872-7826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |