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Organization
BRIANNA'S HOME
Active
Organization
BRIANNA'S HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO LAFEVE BALL (PROVIDER)
(313) 657-4282
Entity
Organization
Contact information
Practice address
16131 LINWOOD ST, DETROIT, MI 48221-3122
(313) 345-3199
(313) 345-3610
Mailing address
16131 LINWOOD ST, DETROIT, MI 48221-3122
(313) 345-3199
(313) 345-3610
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
AS820083566
MI
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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