| NPI | 1932289758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAOMI KENNEDY Propvider 313-274-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |