Organization
LOUISIANA HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LILLIA ROSE DODSON B.A. BUSINESS ADMINI (CHIEF EXECUTIVE OFFICER)
(313) 868-8724
Entity
Organization
Contact information
Practice address
1950 WEBB STREET, DETROIT, MI 48206-1282
(313) 868-8724
(313) 883-5023
Mailing address
1950 WEBB STREET, DETROIT, MI 48206-1282
(313) 868-8724
(313) 883-5023
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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