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Organization
LOUISIANA HOME, INC.
Active
Organization
LOUISIANA HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILLIA ROSE DODSON B.A. BUSINESS ADMINI (CHIEF EXECUTIVE OFFICER)
(313) 868-8724
Entity
Organization
Contact information
Practice address
1950 WEBB STREET, DETROIT, MI 48206-1282
(313) 868-8724
(313) 883-5023
Mailing address
1950 WEBB STREET, DETROIT, MI 48206-1282
(313) 868-8724
(313) 883-5023
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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