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Organization

LAYING THE FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHERINE JOAN BLAKLEY (PRESIDENT/CEO)
(313) 478-3901
Entity
Organization

Contact information

Practice address
21370 RIDGEDALE ST, OAK PARK, MI 48237-2708
(248) 546-7681
Mailing address
21370 RIDGEDALE ST, OAK PARK, MI 48237-2708
(248) 546-7681

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251S00000X
Community/Behavioral Health Agency
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
11/20/2008
Last updated
11/20/2008
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