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Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JIMAVIS ARNOLD BSN,RN (ADMINISTRATOR)
(313) 395-4923
Entity
Organization

Contact information

Practice address
18633 MACKAY ST, DETROIT, MI 48234-1484
(313) 395-4923
Mailing address
18633 MACKAY ST, DETROIT, MI 48234-1484
(313) 395-4923

Taxonomy

Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary

Other

Enumeration date
09/10/2025
Last updated
09/10/2025
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