# KAREN FREDERICK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407234586
- **Authorized official:** MS. JAZMINE M FORD (OWNER)
- **Authorized official phone:** (313) 469-5946

## Contact information

- **Practice address:** 5781 BEACONSFIELD ST, DETROIT, MI 48224-3157
- **Practice address phone:** (313) 469-5946
- **Mailing address:** 5796 BEACONSFIELD ST, DETROIT, MI 48224-3158
- **Mailing address phone:** (313) 469-5946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | AS820367993 | MI | Yes |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | AS820367993 | MI | — |

## Other

- **Enumeration date:** 05/11/2015
- **Last updated:** 05/11/2015