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General NPI Number Information
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NPI Number | 1174605919
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Entity Type | Organization
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Legal Business Name | LIVING SKILLS RESIDENTIAL CENTERS, INC.
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 49167 BEMIS RD
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City | BELLEVILLE
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State | MI
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Zip | 48111-9761
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Country | US
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Telephone | 734-461-2204
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Fax | 734-461-2204
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Provider Business Mailing Address
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Address Line | 321 DEVONSHIRE ST
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City | DEARBORN
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State | MI
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Zip | 48124-1085
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Country | US
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Telephone | 313-274-6137
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Fax | 313-274-6137
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KATHY MCMILLAN
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Credential |
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Telephone | 313-274-6137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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