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General NPI Number Information
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NPI Number | 1790292928
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Entity Type | Organization
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Legal Business Name | GOLDEN POINT COMMUNITY LLC
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Dates
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Enumeration Date | 01/09/2018
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 4777 E OUTER DR
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City | DETROIT
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State | MI
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Zip | 48234-3241
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Country | US
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Telephone | 248-495-8985
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Fax | 248-862-5665
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Provider Business Mailing Address
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Address Line | 6269 POTOMAC CIR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2125
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Country | US
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Telephone | 248-495-8985
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KARICIA REGENE CARTER
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Credential |
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Telephone | 248-495-8985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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