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General NPI Number Information
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NPI Number | 1912433822
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Entity Type | Organization
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Legal Business Name | A CARING HOME OF MICHIGAN LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 45750 W 11 MILE RD
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City | NOVI
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State | MI
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Zip | 48374-2406
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Country | US
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Telephone | 248-252-8888
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Fax | 888-740-2050
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Provider Business Mailing Address
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Address Line | PO BOX 81
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City | WALLED LAKE
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State | MI
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Zip | 48390-0081
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Country | US
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Telephone |
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Fax | 888-740-2050
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TAMISHA KAPLAN
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Credential |
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Telephone | 248-252-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | AS630298741
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License Number State | MI
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