NPI | 1982383196 |
---|---|
Entity Type | Organization |
Authorized Contact | LATISHA BLACKWELL Owner/Executive Director 313-138-2820 |
Organization Subpart ? | No |
Primary Taxonomy | 3747A0650X Technician Attendant Care Provider |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Enumeration Date | 2023-07-14 |
Last Update Date | 2023-07-14 |