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General NPI Number Information
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NPI Number | 1235679960
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Entity Type | Organization
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Legal Business Name | CARE WITHIN CARE HOUSING, INC
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 11256 ENGLESIDE ST
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City | DETROIT
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State | MI
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Zip | 48205-3210
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Country | US
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Telephone | 313-459-9572
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Fax |
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Provider Business Mailing Address
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Address Line | 11256 ENGLESIDE
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City | DETROIT
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State | MI
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Zip | 48205
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Country | US
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Telephone | 313-459-9572
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DORSHON PRATT
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Credential |
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Telephone | 313-459-9572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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