Organization
LEWISITE INC
Active
Other names
Charlotte's Care
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE COLEMAN (CEO)
(248) 761-7452
Entity
Organization
Contact information
Practice address
424 SAINT JOHN ST, WYANDOTTE, MI 48192-2947
(248) 761-7452
Mailing address
424 SAINT JOHN ST, WYANDOTTE, MI 48192-2947
(248) 761-7452
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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