| NPI | 1518822899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTAVEUS BROWN Owner 810-938-2096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-12-18 |
| Last Update Date | 2026-02-11 |