Organization
MICHIGAN HAVEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAWANDA SMITH MBA (MANAGING MEMBER)
(248) 993-6147
Entity
Organization
Contact information
Practice address
19595 MAHON ST, SOUTHFIELD, MI 48075-3939
(248) 993-6147
Mailing address
19595 MAHON ST, SOUTHFIELD, MI 48075-3939
(248) 993-6147
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
311Z00000X
Custodial Care Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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