| NPI | 1568074862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEAU DEESE Owner 248-789-8504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251E00000X Home Health | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |