Organization
AB KHA #1 PLACE ADULT CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODRICK BARNES (CEO)
(313) 627-5885
Entity
Organization
Contact information
Practice address
20815 MONTROSE AVE, WARREN, MI 48089-3464
(313) 627-5885
Mailing address
PO BOX 5192, WARREN, MI 48090-5192
(313) 627-5885
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
MI
Other
Enumeration date
09/28/2013
Last updated
09/28/2013
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