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General NPI Number Information
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NPI Number | 1225381775
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Entity Type | Organization
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Legal Business Name | ADVOCATES FOR SELF-DETERMINATION LLC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 237 N OLD WOODWARD AVE STE 5
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City | BIRMINGHAM
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State | MI
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Zip | 48009-5305
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Country | US
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Telephone | 248-723-7152
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Fax | 248-723-7162
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Provider Business Mailing Address
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Address Line | 237 N OLD WOODWARD AVE STE 5
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City | BIRMINGHAM
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State | MI
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Zip | 48009-5305
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Country | US
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Telephone | 248-723-7152
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Fax | 248-723-7162
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JANET PATTERSON
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Credential |
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Telephone | 248-723-7152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities 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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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