Organization
BENTON'S ABSOLUTE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAISY BENTON (CEO)
(313) 588-0180
Entity
Organization
Contact information
Practice address
669 VIRGINIA PARK ST, DETROIT, MI 48202-2011
(313) 588-0180
Mailing address
669 VIRGINIA PARK ST, DETROIT, MI 48202-2011
(313) 588-0180
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
AS820289178
MI
Other
Enumeration date
02/25/2015
Last updated
02/25/2015
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