MEDICARE: CARE AND TRANSFORMATION CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility		MI

General Provider Information

NPI Number	:	1932557717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE AND TRANSFORMATION CENTER

Provider Business Mailing Address
First Line	:	2311 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4842
Country	:	US
Telephone Number	:	586-983-9280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4842
Country	:	US
Telephone Number	:	586-983-9280
Fax Number	:

Authorized Official
Title or Position	:	LPC
Name	:	DR. HAITHEM SAFO
Credential	:
Telephone Number	:	586-983-9280

Provider Enumeration Date	:	06/02/2016
Last Update Date	:	06/02/2016

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