Organization
LIBERAL MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN BLANCHE DAVIS (ADMINISTRATOR)
(313) 874-5404
Entity
Organization
Contact information
Practice address
129 VIRGINIA PARK ST, DETROIT, MI 48202-2000
(313) 874-5404
(248) 208-0024
Mailing address
14981 LIBERAL ST, DETROIT, MI 48205-1905
(313) 526-0693
(248) 208-0024
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MI
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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