# DON BOSCO HALL

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

## Provider details

- **NPI number:** 1518110386
- **Authorized official:** MR. CHARLES SMALL LMSW (EXECUTIVE DIECTION)
- **Authorized official phone:** (313) 834-8677

## Contact information

- **Practice address:** 10001 PETOSKEY AVE, DETROIT, MI 48204-3908
- **Practice address phone:** (313) 834-8677
- **Mailing address:** 10001 PETOSKEY AVE, DETROIT, MI 48204-3908
- **Mailing address phone:** (313) 834-8677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | C1820201096 | MI | Yes |

## Other

- **Enumeration date:** 10/24/2008
- **Last updated:** 10/24/2008