| NPI | 1538038997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE HURST Owner 734-363-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |