Organization
FAITH AFC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKEISHA BROWN (ADMINISTRTOR)
(313) 529-8808
Entity
Organization
Contact information
Practice address
30440 OLD STREAM ST, SOUTHFIELD, MI 48076-1098
(248) 433-1261
Mailing address
PO BOX 273, SOUTHFIELD, MI 48037-0273
(248) 433-1261
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AS820238444
MI
320700000X
Physical Disabilities Residential Treatment Facility
AS8202384444
MI
Other
Enumeration date
12/15/2010
Last updated
12/15/2010
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