Healthcare Provider Details

I. General information

NPI: 1326903501
Provider Name (Legal Business Name): RANCCOR TRANSITIONAL & RECOVERY HOUSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13229 CHANDLER PARK DR
DETROIT MI
48213-3644
US

IV. Provider business mailing address

13229 CHANDLER PARK DR
DETROIT MI
48213-3644
US

V. Phone/Fax

Practice location:
  • Phone: 248-678-4815
  • Fax:
Mailing address:
  • Phone: 248-678-4815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMES A WEBB
Title or Position: VICE PRESIDENT
Credential:
Phone: 248-678-4815