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General NPI Number Information
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NPI Number | 1407738164
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Entity Type | Organization
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Legal Business Name | FORREST HAVEN LTD.
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 867 E GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48207-2551
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Country | US
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Telephone | 313-704-4990
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Fax |
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Provider Business Mailing Address
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Address Line | 867 E GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48207-2551
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Country | US
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Telephone | 313-704-4990
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RODNEY ROBINSON
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Credential |
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Telephone | 313-922-6006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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