Healthcare Provider Details

I. General information

NPI: 1811418270
Provider Name (Legal Business Name): COMPASSIONATE HEARTS TRANSITIONAL HOUSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20944 RIDGEMONT RD
HARPER WOODS MI
48225-1168
US

IV. Provider business mailing address

20944 RIDGEMONT RD
HARPER WOODS MI
48225-1168
US

V. Phone/Fax

Practice location:
  • Phone: 586-244-3217
  • Fax: 586-244-3217
Mailing address:
  • Phone: 586-244-3217
  • Fax: 586-244-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAREDA WATKINS
Title or Position: MANAGER
Credential:
Phone: 586-244-3217