Organization
MILLER & MOSS AFC
Active
Other names
Rose's Place II
Organization subpart
No
Provider details
NPI number
Authorized official
CHARISE MUHAMMAD (VICE PRESIDENT)
(313) 758-8075
Entity
Organization
Contact information
Practice address
3638 IRENE ST, INKSTER, MI 48141-2127
(734) 405-0846
(734) 895-8873
Mailing address
3409 IRENE ST, INKSTER, MI 48141-2124
(734) 721-9630
(734) 895-8873
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
AS820295801
MI
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AS820295801
MI
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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