| NPI | 1780767707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA LUM Director 313-640-1965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MI AS820094099) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |