| NPI | 1760204697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANTANNA LIVELY Owner 313-340-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |