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General NPI Number Information
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NPI Number | 1902478084
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Entity Type | Organization
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Legal Business Name | XAVIER UNIQUE PLACE FOR US NORTH
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 4783 HAGGERTY RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-3900
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Country | US
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Telephone | 248-592-7193
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Fax |
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Provider Business Mailing Address
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Address Line | 18234 FREELAND ST
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City | DETROIT
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State | MI
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Zip | 48235-2536
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Country | US
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Telephone | 248-592-7193
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LAVERNE R HILL
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Credential |
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Telephone | 248-469-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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