| NPI | 1619374899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLY PEARL HAYES Executive Director 734-459-6424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS820014194) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |