| NPI | 1679822431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEANA LOUISE WALDBURG Owner 313-434-5810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: MI As820316694) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |