Organization
RESIDENTIAL OUTREACH COMMUNITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL CARSON (OWNER)
(313) 790-4032
Entity
Organization
Contact information
Practice address
6795 GLENWAY DR, WEST BLOOMFIELD, MI 48322-3910
(313) 790-4032
Mailing address
6795 GLENWAY DR, WEST BLOOMFIELD, MI 48322-3910
(313) 790-4032
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
06/06/2024
Last updated
06/06/2024
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