| NPI | 1619041183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BLANCHE DAVIS Administrator 313-874-5404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |