Organization
URBAN ENTERPRISE
Active
Other names
MGS Haven
Organization subpart
No
Provider details
NPI number
Authorized official
VALNEDRA JAMILLE SHROPSHIRE (LICENSEE)
(313) 549-8546
Entity
Organization
Contact information
Practice address
17558 MONICA ST, DETROIT, MI 48221-2635
(313) 345-3489
Mailing address
17558 MONICA ST, DETROIT, MI 48221-2635
(313) 345-3489
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MI
320700000X
Physical Disabilities Residential Treatment Facility
—
MI
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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