| NPI | 1720268063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERRITA RENEE FOUNTAIN Operations Manager 313-883-4515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: MI AS820268828) |
| Enumeration Date | 2007-11-04 |
| Last Update Date | 2007-11-04 |