Organization
DOMUS VITA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA JABLONICKY (EXECUTIVE DIRECTOR)
(734) 293-0034
Entity
Organization
Contact information
Practice address
14145 FARMINGTON RD, LIVONIA, MI 48154-5422
(734) 293-0034
(734) 293-0048
Mailing address
14145 FARMINGTON RD, LIVONIA, MI 48154-5422
(734) 293-0034
(734) 293-0048
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
07/30/2024
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