Organization
DAS II RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE BLAKLEY MBA (EXECUTIVE DIRECTOR)
(313) 826-1593
Entity
Organization
Contact information
Practice address
13301 MOUND RD, DETROIT, MI 48212-2545
(313) 826-1593
Mailing address
13301 MOUND RD, DETROIT, MI 48212-2545
(313) 826-1593
(313) 826-1595
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
822784
MI
Other
Enumeration date
09/17/2007
Last updated
11/20/2008
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